Commonly prescribed brands:
How it is given:
What it is used for:
To lower LDL (bad) cholesterol, and total cholesterol
You should not be treated with it if:
You have been diagnosed with active liver disease and are currently taking a statin
Possible side effects:
No significant side effects have been found for ezetimibe alone. For combined treatment with statins, see statins side effects and risks.
What is ezetimibe?
Ezetimibe belongs to a new class of cholesterol-lowering medications called cholesterol absorption inhibitors. It is the first of these drugs to be sold in the US and was approved by the Food and Drug Administration (FDA) in October 2002. Ezetimibe prevents cholesterol from being absorbed in your small intestine. Because you need some cholesterol, your body must use cholesterol stored in the liver and take more cholesterol out of the bloodstream.143 The overall effect is that the LDL (bad) cholesterol and total cholesterol levels in your blood go down.
Currently, there is only one form of ezetimibe available, under the brand name Zetia. Another medication, sold as Vytorin, is a combination pill of ezetimibe and the statin simvastatin (Zocor).
How does ezetimibe affect my cholesterol levels?
When used alone, ezetimibe reduces LDL cholesterol levels by 18% and total cholesterol by 13% in men and women with high cholesterol.144-146 It increases HDL (good) cholesterol a little (about 1%) and lowers triglycerides (about 8%), another type of lipid that increases your risk of heart disease.
Does ezetimibe prevent heart attacks or dying from heart disease?
Because ezetimibe is relatively new, it is not yet known whether it can prevent heart disease or heart attacks. So far, no studies have been done in men or women to test for these effects.
Why do I need to take ezetimibe and a statin?
Ezetimibe is often prescribed along with a statin. This combination can be taken in a single pill (Vytorin) or as two separate prescriptions. Combining ezetimibe with a statin lowers LDL cholesterol an additional 12% to 14% compared with a statin alone.147-150 The benefits are the same for men and women. This combination therapy also lowers triglycerides an extra 10% compared with a statin alone and increases HDL (good) cholesterol by 2% to 5% more. LDL cholesterol levels may be reduced by 33% to 57% depending on the statin and the dose.
The ezetimibe/statin combination is not associated with the increased risk of serious side effects seen when another type of lipid-lowering drug, the fibrates, are combined with statins. Additionally, a low-dose combination (10 mg ezetimibe and 10 mg statin) is just as effective as the highest dose of statin at lowering LDL cholesterol. The risk of side effects increases for higher doses of statins; combining these two medications at lower doses instead may help some people avoid these problems.
Is ezetimibe combined with other cholesterol medications?
When cholesterol medications are combined, one of the drugs is usually a statin because these medications are the most effective for lowering LDL (bad) cholesterol and they reduce the risk of dying from heart disease. However, some people cannot take statins because of side effects, and other combinations may help them reach their cholesterol goals. When ezetimibe is combined with the fibrate fenofibrate (Tricor), LDL cholesterol is lowered by 20%.86 Total cholesterol, HDL cholesterol, and triglyceride levels also improve more than with ezetimibe alone.
What are the major risks and side effects of ezetimibe?
So far, no major risks or side effects have been found for ezetimibe. When ezetimibe is combined with a statin, the same risks and side effects that are seen for statins apply (see Statins).