BMA Concise Guide to Medicine & Drugs

Ezetimibe

Brand name Ezetrol

Used in the following combined preparation Inegy

QUICK REFERENCE

Drug group Lipid-lowering drug

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Ezetimibe is a lipid-lowering drug that is used to treat hypercholesterolaemia (high levels of cholesterol in the blood) in people at risk of developing heart disease. It works in the small intestine to reduce the absorption of cholesterol.

Ezetimibe is prescribed in conjunction with a low-fat diet and usually in combination with a statin (a drug that blocks the action, in the liver, of an enzyme needed for the manufacture of cholesterol). It is also prescribed alone to people in whom a statin is considered inappropriate or is not tolerated.

Common side effects of ezetimibe include headache, abdominal pain and diarrhoea. It is important to notify your doctor if you are taking over-the-counter statins. When ezetimibe is combined with statins, it can, rarely, cause marked muscle pain, weakness, or tenderness, which should be reported to your doctor immediately. This is less likely to occur when ezetimibe is used alone.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets.

Frequency and timing of doses Once daily.

Adult dosage range 10mg daily.

Onset of effect Two weeks.

Duration of action 24 hours.

Diet advice A low-fat diet is usually recommended.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 12 hours, do not take the missed dose, but take the next one on schedule.

Stopping the drug Do not stop taking the drug without consulting your doctor. Stopping the drug may lead to a recurrence of the original condition.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. But if you notice any unusual symptoms or if a large overdose has been taken, notify your doctor.

POSSIBLE ADVERSE EFFECTS

The most common adverse effects of ezetimibe include headache, fatigue, abdominal pain, and diarrhoea. More rarely, the drug may cause nausea or joint pain. Discuss with your doctor if any of these symptoms are severe or if the drug causes bleeding or bruising. If you develop a rash, swelling of the face or tongue, or muscle pain or weakness, stop taking the drug and contact your doctor without delay.

INTERACTIONS

Fibrates (e.g. gemfibrozil, bezafibrate) These drugs, which also reduce cholesterol, may raise levels of ezetimibe.

Colestyramine may reduce the effects of ezetimibe. Ezetimibe should be taken either 2 hours before or 4 hours after colestyramine.

Ciclosporin The levels of both drugs may be increased when they are taken together.

Warfarin If ezetimibe is added to warfarin the INR (International Normalized Rate, a standardized measure of blood clotting) should be closely monitored.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have liver problems.

· You are taking a statin.

· You have lactose intolerance or glucose-galactose malabsorption.

· You are taking other medicines.

Pregnancy Not usually prescribed. Safety not established. Discuss with your doctor.

Breast-feeding Not usually prescribed. It is not known whether the drug passes into the breast milk. Discuss with your doctor.

Infants and children Not recommended under 10 years.

Over 60 Increased likelihood of adverse effects.

Driving and hazardous work No special problems.

Alcohol No special problems.

PROLONGED USE

No known problems.

Monitoring Regular blood tests to check the drug’s effectiveness in reducing cholesterol levels may be performed. Blood tests of liver and muscle function may also be carried out.