Like all medications, these drugs can cause side effects. But most of the time, the problems are mild. In many cases, they go away after you take the drug for a while. Some problems, though, can be severe. Older adults may be more sensitive to the side effects of this medication, especially muscle problems. Administer orally in the evening without regard to meals.
Rossebø AB, Pedersen TR, Boman K et al. Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis. N Engl J Med. Pedersen TR, Berg K, Cook TJ, Faergeman O, Haghfelt T, Kjekshus J, Miettinen T, Musliner TA, Olsson AG, Pyorala K, Thorgeirsso "Safety and tolerability of cholesterol lowering with simvastatin during 5 years in the scandinavian simvastatin survival study. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Alvarez JM, Rawdanowiz TJ, Goldstein J "Rhadbdomyolysis after coronary artery bypass grafting in a patient receiving simvastatin. Take this medication by mouth as directed by your doctor, usually once daily with or without food. Take a brief break. Get a lower dosage.
American College of Cardiology recommend that people with be treated with a statin. These guidelines recommend increasing the statin dose in certain populations, but do not recognize target serum cholesterol levels or recommend the use of non-statin cholesterol lowering drugs. Some MEDICINES MAY INTERACT with ezetimibe. Approximately 22 hours for both ezetimibe and ezetimibe glucuronide.
This combination medication is used along with a proper diet to help lower "bad" cholesterol and fats such as LDL, triglycerides and raise "good" cholesterol HDL in the blood. Ezetimibe works by reducing the amount of cholesterol your body absorbs from your diet. Simvastatin belongs to a group of drugs known as "statins. Ezetimibe inhibits the absorption of from the and decreases the amount of cholesterol normally available to cells, leading them to absorb more from circulation and thus lowering levels of circulating cholesterol. Ezetimibe is to be used only by the patient for whom it is prescribed. Do not share it with other people. Plosker GL, Mctavish D "Simvastatin - a reappraisal of its pharmacology and therapeutic efficacy in hypercholesterolaemia. Sometimes, none of the treatments work. In that case, you might need a liver transplant. The new will have normal LDL receptors that will remove the bad cholesterol from your blood. Ezzet F, Krishna G, Wexler DB et al. A population pharmacokinetic model that describes multiple peaks due to enterohepatic recirculation of ezetimibe. Clin Ther. Moderate. These medicines may cause some risk when taken together. An International Atherosclerosis Society Position Paper: global recommendations for the management of dyslipidemia--full report". J Clin Lipidol. Reductions in serum lipoprotein and apolipoprotein concentrations maintained during continued therapy. Cholesterol is waxy stuff that's in your cells. 's job is to carry cholesterol around your body in your bloodstream. European Atherosclerosis Society, the Japan Atherosclerosis Society, the National Institute for Health and Clinical Excellence, and the International Atherosclerosis Society recommend ezetimibe as one of several second line treatment options for people who are intolerant of statins or who are unable to reach serum LDL goals using statins alone. This drug may rarely cause muscle problems which can rarely lead to very serious conditions called rhabdomyolysis and autoimmune myopathy. Bjerre LM, LeLorier J "Do statins cause cancer? Many people have both conditions.
Ezetimibe may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Chan MH, Mak TW, Chiu RW, Chow CC, Chan IH, Lam CW "Simvastatin increases serum osteocalcin concentration in patients treated for hypercholesterolaemia. Importance of adherence to a standard cholesterol-lowering diet. Its effectiveness in reducing in clinical trials has been inconsistent. The question of whether ezetimibe could make a difference in major outcomes was examined in the IMPROVE-IT trial, which compared treatment with ezetimibe vs. placebo on top of a background regimen of statin therapy in people who have had recent episodes of acute coronary syndrome over a six-year period. It works by reducing the amount of cholesterol made by the liver. Have you noticed any yellowish patches on your skin? Distributed into milk in rats; not known whether distributed into human milk. 1 Use in nursing women not recommended unless potential benefits justify possible risks to infant. Some cholesterol medications should not be taken at the same time. Do not take ezetimibe with Prevalite, Questran Colestid or Welchol. Wait at least 4 hours after taking any of these medicines before you take ezetimibe. You may also take ezetimibe 2 hours before taking any of these other medicines. All medicines may cause side effects, but many people have no, or minor, side effects. Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Preliminary results of this study in approximately 1900 patients revealed a higher incidence of cancer and fatal cancer in patients receiving fixed-combination preparation 11. Make sure you have a support network in place that you can give you an emotional lift when you need it. You can also join a support group to get ideas and help from other people who know what you're going through.
It's important to be patient and take the time to get the right treatment plan for you. Sometimes your doctor might need to try several different things before your high cholesterol gets under control. ASCVD risk reduction benefits compared to their potential for adverse effects in the routine prevention of ASCVD. Retrieved 15 July 2016. You may hear the term heterozygous familial hypercholesterolemia. This is a related disease. With it, you inherit the broken gene from only one of your parents. It's not as severe as the homozygous form. Inc. Vytorin ezetimibe and simvastatin tablets prescribing information. Whitehouse Station, NJ; 2012 Jun. Take this medication regularly in order to get the most benefit from it. Remember to take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with or do not feel sick. Abernethy DR, Greenblatt DJ, Morse DS, Shader RI "Interaction of propoxyphene with diazepam, alprazolam and lorazepam. Patients taking niacin also suffered fewer and other problems than those in the Zetia group, but that finding could have been due to chance, Taylor says. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Summary of the second report of the National Cholesterol Education Program NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Adult Treatment Panel II. JAMA. Ezetimibe in combination with a statin: Upper respiratory tract infection, 1 2 4 12 headache, 1 2 4 12 back pain, 1 influenza, 12 myalgia, 12 abdominal pain, 1 sinusitis, 1 arthralgia, 1 diarrhea, 1 pharyngitis, 1 pain in extremity, 12 chest pain, 1 4 dizziness. In other patients, elevations in liver function tests were transient and returned to normal with continued simvastatin therapy. If you take ezetimibe too close to taking your bile acid sequestrant, your bile acid sequestrant may prevent your body from absorbing ezetimibe. See Special Populations under Dosage and Administration. If you miss a dose of ezetimibe, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you have any questions about ezetimibe, please talk with your doctor, pharmacist, or other health care provider. The concomitant administration of food high-fat vs. nonfat meals has no effect on the extent of absorption of ezetimibe. However, coadministration with a high-fat meal increases the C max of ezetimibe by 38%. The absolute bioavailability cannot be determined, since ezetimibe is insoluble in aqueous media suitable for injection. Ezetimibe and its active metabolite are highly bound to human plasma proteins 90%.
Effects on cardiovascular morbidity and mortality not established. Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. Severe allergic reactions rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness; burning, numbness, or tingling; change in the amount of urine produced; confusion; depression; difficult, frequent, or painful urination; fever, chills, or persistent sore throat; joint pain; memory problems; muscle tenderness, pain, or weakness with or without fever and fatigue; persistent pain, soreness, redness, or swelling of a tendon or joint; red, swollen, blistered, or peeling skin; severe stomach or back pain with or without nausea or vomiting; symptoms of liver problems eg, dark urine, loss of appetite, pale stools, severe stomach pain, yellowing of the skin or eyes. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Bioavailability is variable. 1 Absolute bioavailability cannot be determined because ezetimibe is virtually insoluble in aqueous media suitable for injection. Two editorials accompanying the findings in The New England Journal of Medicine raised questions about the findings. Schering-Plough, PA: Personal communication. Your doctor may try to reduce how much of your medicine you take. You might also be able to take a pill every other day instead of daily.
If your symptoms do not improve or if they become worse, check with your doctor. No dosage adjustment needed. Talk to your pharmacist if you have questions about this information. This drug may increase the risk of liver damage when taken with a "statin" or muscle damage when taken with a fibrate or "statin". Following oral administration, ezetimibe is absorbed and extensively conjugated to a phenolic glucuronide active metabolite. The impotence resolved within 2 weeks after the HMG-CoA reductase inhibitor was discontinued. Halkin A, Lossos IS, Mevorach D "HMG-CoA reductase inhibitor-induced impotence. No differences in pharmacokinetic parameters between blacks and Caucasians. 1 Studies in Asian individuals indicated similar pharmacokinetics as observed in Caucasian individuals. Remember that your doctor has prescribed this because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication not have serious side effects. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. At a news conference at the AHA meeting Sunday night, Taylor reported that the "winner" was Niaspan. If you also take certain other drugs to lower your cholesterol bile acid-binding resins such as cholestyramine or colestipol take this product at least 2 hours before or at least 4 hours after taking these medications. These medications can react with this product, preventing its full absorption. Lab tests, including liver function and cholesterol levels, may be performed while you use ezetimibe. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
Known hypersensitivity to ezetimibe or any ingredient in the formulation. Product Information. Zetia ezetimibe. Use alone or in combination with a hydroxymethylglutaryl-coenzyme A HMG-CoA reductase inhibitor statin as an adjunct to dietary therapy to decrease elevated serum total cholesterol, LDL-cholesterol, and apolipoprotein B apo B concentrations in the treatment of primary heterozygous familial and nonfamilial hypercholesterolemia. Maximal or near-maximal reductions in serum lipoprotein and apolipoprotein concentrations achieved within 2 weeks. The usual maximum dose for the simvastatin in this medication is 40 milligrams a day. If you have been instructed by your doctor to take more than 40 milligrams of simvastatin, continue on that same dose. However, promptly talk with him or her about the risks and benefits of your higher dose. Adjunct to dietary therapy to decrease elevated serum sitosterol and campesterol concentrations in patients with homozygous familial sitosterolemia. Schering-Plough Pharmaceuticals. Zetia ezetimibe tablets prescribing information. North Wales, PA; 2006 May. Follow your diet, medication, and exercise routines very closely. Reductions in sitosterol and campesterol concentrations were consistent between patients receiving ezetimibe with or without bile acid sequestrants. Even brisk walking counts, so you don't need a gym. Side Effects List Ezetimibe side effects by likelihood and severity. Store at room temperature between 68-77 degrees F 20-25 degrees C away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets. Maxa JL, Melton LB, Ogu CC, Sills MN, Limanni A "Rhabdomyolysis after concomitant use of cyclosporine, simvastatin, gemfibrozil, and itraconazole. Do not share this medication with others. If you're considering a liver transplant, you'll probably need to get some emotional support from family and friends. Support groups can also help by putting you in touch with people who are also getting transplants. Ask your doctor about educational workshops that can help explain what to expect before and after a transplant.
Do I need to change my diet? Tell your doctor how your medicine makes you feel. Often, there are ways you can handle these side effects and still get the help you need for your cholesterol. Your doctor may also try combining with other drugs that lower the amount of cholesterol that gets into your body from the food you eat. is one of these drugs. It's a well-understood drug, and in this trial it was clearly superior. Take this by with or without food as directed by your doctor, usually once daily in the evening. Feldmann R, Mainetti C, Saurat JH "Skin lesions due to treatment with simvastatin Zocor.
Talk to your doctor about the benefits and risks. You'll need to manage your condition throughout your life. Make sure you keep up with the drugs your doctor prescribes, and keep eating a healthy diet. When used in combination or fixed combination with a statin or fenofibrate, consult prescribing information of specific statin or fenofibrate for detailed information on usual cautions, precautions, and contraindications of these drugs. This is an ongoing condition in which the heart loses the ability to pump effectively. The main symptoms are shortness of breath when you're moving and leg swelling. Simons LA "Simvastatin in severe primary hypercholesterolemia: efficacy, safety, and tolerability in 595 patients over 18 weeks. The Principal Investigators. Buildup of cholesterol and fats along the walls of the blood vessels a process known as atherosclerosis decreases blood flow, which decreases the oxygen supply to the heart, brain, and other parts of the body. Lowering blood levels of cholesterol and fats may help reduce this buildup and may decrease your chances of developing heart conditions such as angina chest pain strokes, and heart attacks. Results of a clinical study that compared people who took ezetimibe and simvastatin with people who took simvastatin alone found that although the group of people taking ezetimibe and simvastatin had lower amounts of cholesterol in the blood, there was no difference between the two groups in the amount of cholesterol and fat buildup on the insides of the blood vessels in the neck. It is not currently understood why the additional lowering of cholesterol levels in the blood did not lead to a greater decrease in cholesterol and fat buildup along the walls of the blood vessels in people taking ezetimibe and simvastatin. Further studies are underway to compare treatment with ezetimibe and simvastatin to treatment with simvastatin alone to see if there is a difference in the risk of developing heart disease. Talk to your doctor if you have questions about the risks and benefits of treating increased amounts of cholesterol in your blood with ezetimibe and other medications. Your doctor will check your by taking a blood sample and sending it to a lab to be analyzed. The patient developed gradual memory loss following 12 months of simvastatin therapy. He was switched to pravastatin, and within a month his memory was intact. Rechallenge with simvastatin was not performed. Store at room temperature between 68-77 degrees F 20-25 degrees C away from light and moisture. not store in the bathroom. Keep all medicines away from children and pets. If diet and drugs don't lower my cholesterol, are there other treatments that can help?
Ezetimibe is an antihyperlipidemic agent. It works by reducing the amount of cholesterol that your body absorbs from your diet. Atorvastatin is an HMG-CoA reductase inhibitor or "statin. It's major surgery with a lot of recovery time, so it's important to reach out to family and friends to get the emotional support you need. When you have homozygous familial hypercholesterolemia, you inherit two copies of a gene that isn't working right, one from each of your parents. Use in combination with fenofibrate as an adjunct to dietary therapy to decrease elevated serum total cholesterol, LDL-cholesterol, apo B, and non-HDL-cholesterol concentrations in the treatment of mixed dyslipidemia. 1 Effects on cardiovascular morbidity and mortality not established. 1 Use with a fibric acid derivative other than fenofibrate not studied and currently not recommended. 1 See Specific Drugs under Interactions. See Renal Impairment under Cautions. It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding. Vanpuijenbroek EP, Dubufvereijken PWG, Spooren PFMJ, Vandoormaal JJ "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil. No substantial differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out. This may not be a complete list of all interactions that may occur. Ask your health care provider if ezetimibe may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. Chagnon JP, Cerf M "Simvastatin-induced protein-losing enteropathy. This may not be a complete list of all interactions that may occur. Orsi A, Sherman O, Woldeselassie "Simvastatin-associated memory loss. Safety of increased exposure to ezetimibe in patients with moderate or severe hepatic impairment currently not known; use not recommended in such patients. Have you ever noticed that you're short of breath? Will my children inherit my condition? The dosage is based on your medical condition and response to treatment.
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Dujovne CA, Ettinger MP, McNeer JF et al for the Ezetimibe Study Group. Efficacy and safety of a potent new selective cholesterol absorption inhibitor, ezetimibe, in patients with primary hypercholesterolemia. Am J Cardiol. Do not miss any doses. If drugs and diet aren't helping, there's another treatment that takes blood from your body, removes the cholesterol, and then returns the blood back to you.
Walker JF "Simvastatin: the clinical profile. Gagne C, Gaudet D, and Bruckert E for the Ezetimibe Study Group. Efficacy and safety of ezetimibe coadministered with atorvastatin or simvastatin in patients with homozygous familial hypercholesterolemia. Circulation. Ezetimibe may be taken at the same time with Antara, Lipofen, Lofibra, TriCor, Triglide or with any of the "statin" drugs such as Mevacor Zocor Pravachol Lescol Lipitor or cerivastatin Baycol. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as any concomitant illnesses.
Since homozygous familial hypercholesterolemia raises your cholesterol to extremely high levels, your doctor may start you on high doses of statin drugs. work by stopping your from making cholesterol. Ezetimibe may cause side effects. Statins may also be combined with drugs that help reduce the amount of cholesterol that moves through your blood. Approximately 93% of dose is absorbed systemically following oral administration. LDL apheresis or if such treatments are unavailable.
Normally, the removes extra LDL cholesterol from the blood using particles called LDL receptors. These receptors attach to LDL cholesterol and play a key role in keeping your under control. When you have this disease, the faulty gene keeps the LDL receptors from working right. Your get high. National Cholesterol Education Program NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Summary of the third report of the National Cholesterol Education Program NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Adult Treatment Panel III. Bethesda, MD: National Institutes of Health. NIH publication No. 01-3670.