What is Ezetimibe?
Ezetimibe (E-zet-im-ibe) is the name of a medicine that lowers cholesterol, it is often referred to as Ezetrol which is the brand name for the drug. It works in a different way to statins and so is often prescribed alongside a statin because of the added cholesterol lowering it offers.
Ezetimibe also comes as a combination medicine with simvastatin under the brand name Inegy.
Ezetimibe is a “cholesterol absorption inhibitor” which means it works by partially blocking the reabsorption of cholesterol (from the diet and from bile) in the small intestine. As a result less cholesterol is taken to the liver for re-cycling. This means that the liver has to increase its efforts to take more cholesterol out of the blood. It does this by increasing the number of LDL receptors on the surface of liver cells. These LDL receptors literally catch LDL cholesterol particles and remove them from the blood.
Dose and combination
Ezetimibe is taken orally at a dose of 10 mg once daily. Ezetimibe can be combined with a statin to provide a complementary mode of cholesterol reduction or it can be used on its own for those who are intolerant of statins (see below).
A technology appraisal (NICE TA 385) licenced ezetimibe to be used as a monotherapy (single therapy) for treating those with primary hypercholesterolaemia (heterozygous FH or non-familial) who cannot take statins or for whom statins are ineffective. It also allowed for use in combination with a statin when target LDL cholesterol levels are not being reached. This also includes its use in rare conditions such as homozygous FH and sitosterolaemia.
Similar to other medications, ezetimibe is not recommended in pregnancy and should also be avoided in women who are breastfeeding.
When used as a monotherapy any side effects that are experienced are usually mild and temporary. These can include gastrointestinal disturbance, abdominal pain, diarrhoea, flatulence and fatigue.
When taken with a statin, the most common side effects include moderate elevations of liver enzymes, muscle pain and headaches. A full list of reported side effects (common, uncommon and rare) are included in the patient information leaflet which is included with the medication.