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.
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.
Source: Dailymed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
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
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
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.
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.
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 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 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).
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).
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
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
Add-on to diet for people with high cholesterol
Alone or add-on to other cholesterol-lowering medications in people with homozygous familial hypercholesterolemia (HoFH)
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Armitage, J., et al. (2010). Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12 064 survivors of myocardial infarction: a double-blind randomised trial. Lancet.
AvKARE. (2022). EZETIMIBE AND SIMVASTATIN tablet [package insert]. DailyMed.
Family Heart Foundation. (n.d.). Homozygous FH.
Muacevic, A., et al. (2020). Statin-Induced Immune-Mediated Necrotizing Myopathy: An Increasingly Recognized Inflammatory Myopathy. Cureus.
U.S. Food and Drug Administration. (2017). FDA Drug Safety Communication: New restrictions, contraindications, and dose limitations for Zocor (simvastatin) to reduce the risk of muscle injury.
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