Ezetim

Indications

Ezetimibe lowers LDL (bad) cholesterol. It is used, together with a low-fat diet:

• Along with a statin when the statin alone does not lower cholesterol enough
• On its own when a statin is not suitable or not tolerated
• For inherited high cholesterol (familial hypercholesterolaemia)
• For a rare inherited condition with high plant sterol levels (sitosterolaemia)

How It Works

It blocks the absorption of cholesterol from food and bile in the small intestine. Less cholesterol reaches the liver, so the liver takes more out of the blood. With a statin, which reduces cholesterol made in the liver, the two work in different ways and add to each other.

Dosage and Administration

Adults: 10 mg once a day, at any time of day, with or without food. Take it at about the same time each day. Keep following a cholesterol-lowering diet. Use in children only as prescribed by a specialist.

Interactions

• Cholestyramine and similar bile acid binders: take Ezetimibe at least 2 hours before or 4 hours after them.
• Ciclosporin: levels of both medicines may rise; the doctor will monitor.
• Fenofibrate and other fibrates: may increase the risk of gallstones.
• Warfarin: the doctor may check the INR (clotting test) when Ezetimibe is started.

Contraindications

• Allergy to Ezetimibe or any ingredient of the product
• Together with a statin: active liver disease or unexplained raised liver enzymes, and during pregnancy or breastfeeding

Side Effects

Usually mild. Common: stomach pain, diarrhoea, wind, tiredness and headache. When taken with a statin: muscle aches and raised liver enzymes on blood tests.

Get urgent medical help if you have:

• Unexplained muscle pain, tenderness or weakness, especially with fever or dark urine
• Yellow skin or eyes, or severe stomach pain
• Swelling of the face, lips or throat, difficulty breathing, or a widespread rash

Pregnancy and Lactation

Not recommended during pregnancy or breastfeeding, as there is not enough safety information. With a statin it must not be used. Tell the doctor if you are pregnant or planning a pregnancy.

Precautions and Warnings

• Not recommended for people with moderate or severe liver disease.
• The doctor may check liver tests when it is used with a statin.
• Report any muscle pain promptly.
• It works best alongside diet, exercise and weight control.

Overdose

Few problems have been reported, even at high doses. If a large amount is taken, contact a doctor for advice.

Therapeutic Class

Lipid-lowering medicine: cholesterol absorption inhibitor.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.