ezetimibe / simvastatin
Vytorin (ezetimibe / simvastatin) is a combination of two different medications that work together to lower cholesterol in different ways. It lowers "bad" cholesterol and triglyceride levels, while raising "good" cholesterol levels. In doing so, Vytorin (ezetimibe / simvastatin) helps prevent severe and life-threatening medical problems, like heart attack or stroke. But, you should take it in addition to eating a healthy diet and having a regular exercise routine to get the most benefit from the medication.
What is Vytorin (ezetimibe / simvastatin)?
What is Vytorin (ezetimibe / simvastatin) used for?
How Vytorin (ezetimibe / simvastatin) works
Vytorin (ezetimibe / simvastatin) is a combination of two medications that work together to lower cholesterol levels.
- Ezetimibe is a cholesterol absorption inhibitor. It blocks the amount of cholesterol that your body absorbs.
- Simvastatin is a statin. It blocks an enzyme (protein) in your liver from making cholesterol.
Drug facts
Side effects of Vytorin (ezetimibe / simvastatin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (6%)
- Muscle pain (4%)
- Runny nose, cough, and other symptoms of the common cold (4%)
- Diarrhea (3%)
Less Common Side Effects
- Tiredness
- Pain in the arms, hands, legs, feet
- Rash or skin changes
Vytorin (ezetimibe / simvastatin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Muscle breakdown (rhabdomyolysis): muscle weakness, muscle pain, fever, tiredness, dark brown urine
- Serious liver problems: confusion, tiredness, nausea, vomiting, swelling of your stomach, yellowing of your skin or the whites of your eyes, pale-colored stool, dark or brown urine
The following Vytorin (ezetimibe / simvastatin) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Muscle injury—unusual weakness or fatigue, muscle pain, dark yellow or brown urine, decrease in amount of urine
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Back pain
- Diarrhea
- Headache
- Runny or stuffy nose
- Sore throat
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Pros and cons of Vytorin (ezetimibe / simvastatin)
Pros
- More convenient to take a single pill containing two medications that work in different ways
- Lowers "bad" cholesterol (LDL) and raises "good" cholesterol (HDL)
- Taken once daily
- Available as a lower-cost, generic form
Cons
- More difficult to customize the dose since it's a fixed combination of two medications
- Can cause rhabdomyolysis, a life-threatening muscle problem that's a medical emergency
- Works better to if taken at night
- Not safe for people who are pregnant or nursing
Pharmacist tips for Vytorin (ezetimibe / simvastatin)
- Vytorin (ezetimibe / simvastatin) works best if you take it in the evening. This is because simvastatin doesn't stay in your body for the entire day. And also, your body makes most of its cholesterol at night. If you take Vytorin (ezetimibe / simvastatin) during the day, it might not work as well to lower your cholesterol by evening time.
- Take with or without food. Make sure you swallow the tablet whole. Don't cut or crush the tablet because it can affect how the medication works.
- Limit your use of alcohol while taking Vytorin (ezetimibe / simvastatin). This is because alcohol can raise the risk of serious liver problems associated with Vytorin (ezetimibe / simvastatin).
- Vytorin (ezetimibe / simvastatin) interacts with many commonly prescribed medications, such as warfarin (Coumadin), amlodipine (Norvasc), and colchicine (Colcrys). Make sure to let your provider known about all the medications you're taking (including vitamins and supplements) before starting Vytorin (ezetimibe / simvastatin) so that they can help you check for interactions. If there are interactions, your provider might adjust the dose of your medications or ask you to take a different cholesterol-lowering medication besides All other instance of drug name: Vytorin (ezetimibe / simvastatin).
- If you take a bile acid sequestrant, such as cholestyramine (Prevalite) or colesevelam (Welchol), take Vytorin (ezetimibe / simvastatin) at least 2 hours before or 4 hours after the bile acid sequestrant. Taking them together will cause your body to absorb less Vytorin (ezetimibe / simvastatin), so it won't work as well.
- Avoid grapefruit or grapefruit juice while taking Vytorin (ezetimibe / simvastatin) because it can raise the amount of the medication in your body, which raises your risk of side effects.
- It's important that you eat a healthy and balanced diet low in fat and a maintain a regular exercise routine while taking Vytorin (ezetimibe / simvastatin). Doing so will help you get the most benefit out of the medication. Talk with your provider if you have questions about how to plan your meals and what kind of exercise is appropriate for you.
- Vytorin (ezetimibe / simvastatin) isn't safe to take for people who are pregnant or breastfeeding. If you're thinking of getting pregnant while taking Vytorin (ezetimibe / simvastatin), talk to your provider. Your provider can recommend safer ways to control your cholesterol levels during pregnancy.
- Make sure to mark your calendar with your appointments to see your provider and to get any blood work done when you take Vytorin (ezetimibe / simvastatin). Your provider will order blood work to check your cholesterol levels during treatment. They might change your dose of Vytorin (ezetimibe / simvastatin) based on your lab results.
Common questions about Vytorin (ezetimibe / simvastatin)
Vytorin (ezetimibe / simvastatin) contains simvastatin (Zocor), which is a short-acting statin. "Short-acting" means simvastatin's effects on cholesterol don't last the full day. Since your body makes more cholesterol at night, it might be better to take Vytorin (ezetimibe / simvastatin) in the evening. But if taking Vytorin (ezetimibe / simvastatin) at night is difficult for you, ask your provider if it's okay to take it at another time that works for you. The more important thing to keep in mind that it's better to take your Vytorin (ezetimibe / simvastatin) at a time that works best for you than to not take it at all.
Currently, the maximum recommended dose of Vytorin for most people is 10 mg/40 mg (ezetimibe / simvastatin) daily. In 2011, the FDA announced people shouldn't take more than 40 mg of simvastatin daily. This is because results from a large study showed the risk of severe muscle damage was much higher in people taking 80 mg of simvastatin compared to those taking 20 mg or 40 mg of simvastatin. Guidelines from the FDA state that the only people whose provider might prescribe 80 mg of simvastatin are those who've been taking this dose for at least 1 year and didn't experience any muscle damage. If you're currently taking Vytorin 10 mg/80 mg (ezetimibe / simvastatin) daily and have concerns about muscle pain, talk with your provider.
Both Vytorin and Roszet contain a statin in combination with ezetimibe (Zetia). The major difference is that rosuvastatin in Roszet (rosuvastatin / ezetimibe) is considered a moderate-to-high-intensity statin, whereas simvastatin in Vytorin (ezetimibe / simvastatin) is considered a low-to-medium intensity statin. The "intensity" of each statin depends on the dose and represents how much it can lower your LDL. Your provider will decide if you need a lower intensity or higher intensity statin depending on your LDL level and risk factors for medical problems due to high cholesterol.
Though not common, muscle pain is a well-known potential side effect of simvastatin in Vytorin (ezetimibe / simvastatin). For people who do experience muscle pain, it typically comes on when they first start Vytorin (ezetimibe / simvastatin) and fades away in 1 to 2 weeks. But let your provider know if your pain is intense or if it doesn't go away with time. They can recommend possible solutions, such as lowering your dose or change how often you take Vytorin (ezetimibe / simvastatin) (e.g., every other day instead of daily). Or, your provider might switch you to another cholesterol medication, including possibly a different statin because you might not get muscle pain from another statin just because you got muscle from simvastatin in Vytorin (ezetimibe / simvastatin). Be sure to get medical help right away if you also notice dark-colored urine or fever in addition to muscle pain - these might be signs of a very serious condition called rhabdomyolysis (muscle breakdown).
No, you shouldn't take Vytorin (ezetimibe / simvastatin) if you're pregnant or breastfeeding. The FDA encourages pregnant females to stop taking statin-containing medications, like Vytorin (ezetimibe / simvastatin), because it's not clear whether or not it's safe. In addition, Vytorin (ezetimibe / simvastatin) hasn't been well-studied in breastfeeding. But, based on similar medications, it can pass through breast milk and cause harm to breastfed babies. Ask your provider if you have any questions about Vytorin (ezetimibe / simvastatin) and pregnancy or breastfeeding.
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Risks and warnings for Vytorin (ezetimibe / simvastatin)
Vytorin (ezetimibe / simvastatin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe muscle pain and damage
- Risk factors: Older adults | Taking 80 mg of simvastatin | Kidney problems | Taking other medications that can also cause muscle problems or interact with Vytorin (ezetimibe / simvastatin) | History of uncontrolled hypothyroidism
The simvastatin in Vytorin can cause muscle pain, tenderness or weakness. In more serious cases, it can lead to muscle breakdown (rhabdomyolysis), which might be life-threatening. Don't start any new medications without asking your provider or pharmacist first because taking Vytorin (ezetimibe / simvastatin) with certain medications raises your risk for rhabdomyolysis. Your provider might need to adjust the dosages of certain medications if you're taking simvastatin. If you do experience rhabdomyolysis, your provider will most likely switch you to a different medication to lower your cholesterol levels. If you have a fever, muscle pain, or weakness, get medical attention right away.
In some rare cases, statins can cause immune-mediated necrotizing myopathy (IMNM). In these cases, the pain might continue even if you stop taking the statin. If you develop IMNM, your provider will ask you to stop Vytorin (ezetimibe / simvastatin) and might treat you with medications to dampen down your immune system.
Risk of liver problems
- Risk factors: History of liver problems | Drinking large amounts of alcohol
Vytorin (ezetimibe / simvastatin) can cause liver irritations. Most of the time, this doesn't lead to any noticeable symptoms and is only discovered through blood tests. And typically, your liver labs will return to normal once you stop taking Vytorin (ezetimibe / simvastatin), But some people have reported serious liver problems while taking this medication. To be cautious, your provider might ask you to get blood tests to check your liver health before and during treatment to make sure your liver is healthy. Get medical attention right away if you notice symptoms of liver problems, such as nausea, stomach pain, yellowing of your skin or the whites of your eyes, stool changes (black, tarry, or bloody stools). Your provider might ask you to stop taking Vytorin (ezetimibe / simvastatin).
Risk of high blood sugar
- Risk factors: High blood sugar levels
Though not common, some people noticed a rise in their blood sugar levels while taking Vytorin (ezetimibe / simvastatin). Sometimes, this led to a higher hemoglobin A1C level, which is a measurement of the average blood sugar over 3 months. Let your provider know if you have high blood sugar before starting Vytorin (ezetimibe / simvastatin) because they might ask you to monitor your blood sugar more often. Also, make sure to have a healthy, balanced diet and regular exercise while taking Vytorin (ezetimibe / simvastatin).
Vytorin (ezetimibe / simvastatin) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg/10mg | 90 tablets | $46.50 | $0.52 |
| 10mg/20mg | 90 tablets | $40.53 | $0.45 |
| 10mg/40mg | 90 tablets | $44.99 | $0.50 |
| 10mg/80mg | 90 tablets | $45.99 | $0.51 |
Typical dosage for Vytorin (ezetimibe / simvastatin)
The typical dose of Vytorin ranges from 10 mg/10 mg (ezetimibe / simvastatin) to 10 mg/40 mg (ezetimibe / simvastatin) by mouth once daily in the evening.
Your dose of Vytorin (ezetimibe / simvastatin) might differ if you have kidney problems or if you're taking other medications that interact with Vytorin (ezetimibe / simvastatin).
How much does Vytorin (ezetimibe / simvastatin) cost?
Vytorin (ezetimibe / simvastatin) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Vytorin (ezetimibe / simvastatin) will not be safe for you to take.
- Taking Vytorin (ezetimibe / simvastatin) with certain medications that can cause dangerous interactions, such as azole antifungals, macrolide antibiotics, certain antiviral medications, nefazodone, cyclosporine (Neoral, Gengraf, Sandimmune), or gemfibrozil (Lopid)
- Liver problems
- Pregnancy and breastfeeding
What are alternatives to Vytorin (ezetimibe / simvastatin)?
Vytorin (ezetimibe / simvastatin) images
