ezetimibe
Zetia (ezetimibe) is an oral medication used to treat people with high cholesterol by lowering total cholesterol and "bad" cholesterol (LDL) levels in the blood. It generally has few side effects and is commonly taken in addition to or as an alternative to statin medications. And whether you take it alone or with other medications, it's important to continue exercising and eating a healthy diet to get the most treatment benefit.
What is Zetia (ezetimibe)?
What is Zetia (ezetimibe) used for?
Treatment of high cholesterol in certain people
How Zetia (ezetimibe) works
Zetia (ezetimibe) is a cholesterol absorption inhibitor. It works by lowering the amount of "bad" cholesterol (called LDL) that's absorbed from your gut.
Drug Facts
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What are the side effects of Zetia (ezetimibe)?
Common Side Effects
- Upper respiratory tract infection (4%)
- Diarrhea (4%)
- Joint pain (3%)
- Inflamed sinuses (3%)
- Pain in arms or legs (3%)
Other Side Effects
- Rash
- Tiredness
- Headache
- Dizziness
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Frequency not determined
Abdominal fullness
black tarry stools
bleeding gums
blood in urine or stools
chills
darkened urine
fast heartbeat
gaseous abdominal pain
general tiredness or weakness
indigestion
large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
loss of appetite
light-colored stools
muscle cramps or spasms
muscular tenderness, wasting or weakness
pains in stomach, side or abdomen, possibly radiating to the back
pinpoint red spots on skin
recurrent fever
severe nausea
skin rash
unusual bleeding or bruising
upper right abdominal pain
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Back pain
body aches or pain
chills
congestion
difficulty in moving
dizziness
dryness or soreness of throat
hoarseness
muscle pain or stiffness
pain in joints
pain or tenderness around eyes and cheekbones
shortness of breath or troubled breathing
stomach pain
tender, swollen glands in neck
tightness of chest or wheezing
trouble in swallowing
unusual tiredness or weakness
voice changes
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Zetia (ezetimibe)
Pros
Works pretty well to lower "bad" cholesterol (LDL) levels, about 13-20%
Only needs to be taken once per day
Can be taken with or without food at any time of the day
Doesn't have too many side effects
Available as a lower-cost generic
Cons
Hasn't been shown to lower the risk of heart attacks, stroke, or heart disease
Not the best choice for people with moderate to severe liver problems
Can interact with many medications
Doesn't work as well as statins to lower cholesterol if taken alone
Unknown if safe in pregnancy or while breastfeeding
Pharmacist tips for Zetia (ezetimibe)
You can take Zetia (ezetimibe) with or without food. It's best to take it around the same time each day.
Zetia (ezetimibe) interacts with many medications. Make sure to tell your provider about all of the medications you're taking before and during treatment with Zetia (ezetimibe).
If you take a bile acid sequestrant, such as cholestyramine (Prevalite) or colesevelam (Welchol), take Zetia (ezetimibe) at least 2 hours before or 4 hours after the bile acid sequestrant. Taking them together will cause your body to absorb less Zetia (ezetimibe), so it won't work as well.
It's important that you eat a healthy and balanced diet low in fat and maintain a regular exercise routine while taking Zetia (ezetimibe). Doing so will help you get the most benefit out of the medication.
If you accidentally miss a dose of Zetia (ezetimibe), take it as soon as you remember. Don't take two doses of Zetia (ezetimibe) at the same time to make up for any missed doses.
You'll need to have blood work done when taking Zetia (ezetimibe) to check your cholesterol levels. This is done during treatment to make sure the medication is working well for you.
Frequently asked questions about Zetia (ezetimibe)
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What are the risks and warnings for Zetia (ezetimibe)?
Zetia (ezetimibe) 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: Age 65 years and older | Kidney problems | Taking Zetia (ezetimibe) with statins | Uncontrolled hypothyroidism (low thyroid hormone)
Zetia (ezetimibe), especially if taken with a statin, can cause a rare, but serious and life-threatening muscle problem called rhabdomyolysis. This happens when your muscles break down, which can lead to severe kidney problems. If you notice any symptoms of rhabdomyolysis, such as severe muscle pain, dark-colored urine, weakness, or tiredness, stop Zetia (ezetimibe) and get medical attention right away.
Liver problems when taken with a statin
Risk factors: History of liver problems | Taking Zetia (ezetimibe) with statins
When taken with a statin, Zetia (ezetimibe) can cause liver damage. You'll need to get blood tests to check your liver health before and during treatment to make sure your liver is working properly. Typically, any liver damage that occurs gets better after stopping the medication. Get medical attention right away if you notice symptoms of liver problems, such as yellowing of your skin or the whites of your eyes, nausea, vomiting, or dark or brown urine. You might need to stop taking Zetia (ezetimibe) to prevent further liver damage.
Zetia (ezetimibe) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg | 90 tablets | $14.40 | $0.16 |
Typical dosing for Zetia (ezetimibe)
The typical dose is 10 mg by mouth once per day with or without food.
Interactions between Zetia (ezetimibe) and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Bezafibrate
- Ciprofibrate
- Clofibrate
- Gemfibrozil
- Simeprevir
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Zetia (ezetimibe) cost?
What are alternatives to Zetia (ezetimibe)?
Treatment of high cholesterol in certain people
Prevention of heart or blood vessel problems (e.g., heart attack or stroke) in high-risk adults (e.g., diabetes, high blood pressure, family history of cholesterol problems)
Treatment of high "bad" cholesterol and triglyceride levels in certain people
Prevention of heart or blood vessel problems (e.g., heart attack or stroke) in people at higher-risk for heart problems
Lower high "bad" cholesterol and triglyceride levels in certain people
What is the latest news about Zetia (ezetimibe)?
Zetia (ezetimibe) images
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References
Best studies we foundAscend Laboratories, LLC. (2023). EZETIMIBE tablet [package insert]. DailyMed.
Drugs and Lactation Database (LactMed). (2020). Ezetimibe. National Institute of Child Health and Human Development.
Grundy, S. M., et al. (2018). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation.
Simard, C., et al. (2006). Ezetimibe-associated myopathy in monotherapy and in combination with a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor. The Canadian Journal of Cardiology.
Sizar, O., et al. (2023). Ezetimibe. StatPearls.
Slim, H., et al. (2008). Ezetimibe-related myopathy: A systematic review. Journal of Clinical Lipidology.
U.S. Food and Drug Administration. (2021). FDA requests removal of strongest warning against using cholesterol-lowering statins during pregnancy; still advises most pregnant patients should stop taking statins.
Wang, Y., et al. (2022). Safety of ezetimibe in lipid-lowering treatment: Systematic review and meta-analysis of randomised controlled trials and cohort studies. BMJ Medicine.
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