A comparative double blind randomised study of gemfibrozil and lovastatin in hypercholesterolemia

Objective: To evaluate the safety and efficacy of lovastatin in comparison with gemfibrozil in 60 Indian patients with primary hypercholesterolemia (250-350 mg/dL). Methods: After excluding patients with exclusion criteria, 60 adult patients were randomly allocated to the study medication which contained either lovastatin tablets 20 mg or gemfibrozil capsules of 300 mg for 4 weeks and the lipoprotein profile was estimated before and after the treatment. Results: Of the 60 patients, only 44 were available for efficacy analysis, 18 in gemfibrozil group and 26 in lovastatin group and the rest were drop outs. There was a statistically significant reduction in LDL cholesterol from base line value in lovastatin group (32.8%) in comparison with gemfibrozil group (20.35%). Lovastatin was better in raising HDL cholesterol from the base line value (16.3%) in comparison with gemfibrozil (-1.7%). Although there was better reduction in total cholesterol and triglycerides with lovastatin group, this was statistically not significant. Gastrointestinal side effects severe enough to warrant drug withdrawal occurred only in 3.3% (n=1) of lovastatin group as against 33.3% (n=9) of gemfibrozil group. Conclusion: Lovastatin is superior to gemfibrozil in lowering LDL cholesterol and raising HDL cholesterol and it is better tolerated.