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Concurrent use of anticoagulants with gemfibrozil may significantly increase the anticoagulant effect of these medications; adjustments of anticoagulant dosage based on frequent prothrombin time determinations are recommended.
Concurrent use of lovastatin with gemfibrozil may be associated with an increased risk of rhabdomyolysis, significant increases in creatine kinase concentrations and myoglobinuria that leads to acute renal failure; may be seen as early as 3 weeks or as late as several months after initiation of combined therapy; monitoring of creatine kinase has not been shown to prevent severe myopathy or renal damage.
