Atorvastatin Ezetimibe Brand Name– Liptruzet
What is Atorvastatin Ezetimibe
Atorvastatin ezetimibe is an oral antilipemic combination.
Atorvastatin is an HMG-CoA reductase inhibitor (‘statin’). Ezetimibe is a potent cholesterol absorption inhibitor and selectively blocks the intestinal absorption of cholesterol and related phytosterols.
The combination of ezetimibe with a statin results in synergistic cholesterol-lowering effects.
In a study of 628 patients with primary hyperlipidemia, the mean LDL was reduced by 56% in patients randomized to atorvastatin; ezetimibe compared to a 44% reduction with atorvastatin alone.
In another study, 556 patients at high risk for coronary heart disease (CHD) who failed to achieve an LDL cholesterol level of < 70 mg/dL after at least 4 weeks of atorvastatin 40 mg/day PO were randomized to combination therapy with atorvastatin 40mg/day PO and ezetimibe 10 mg/day PO or a double dose of atorvastatin (80 mg/day PO) for 6 weeks. Combination therapy resulted in a 27% reduction in LDL compared with a reduction of 11% with atorvastatin alone. In a study of patients at moderate risk for CHD (n = 168), coadministration of atorvastatin 20 mg/day PO and ezetimibe 10 mg/day PO produced a significantly greater reduction in LDL than doubling the dose of atorvastatin (31% vs. 11%) after 6 weeks.
Despite the significantly greater reductions in LDL demonstrated with combination therapy, no incremental benefit on cardiovascular morbidity and mortality has been demonstrated with atorvastatin; ezetimibe over atorvastatin alone.
Atorvastatin ezetimibe was FDA-approved in May 2013.
Indications
- hypercholesterolemia
- hyperlipoproteinemia
For use as an adjunctive therapy to diet for the reduction of elevated total-C, LDL-C, Apo B, TG, and non-HDL-C, and to increase HDL-C in patients with primary (heterozygous familial and nonfamilial) hypercholesterolemia or mixed hyperlipoproteinemia AND for reduction of elevated total-C and LDL-C in patients with homozygous familial hypercholesterolemia (HoFH) as an adjunct to other lipid-lowering treatments
Side Effects
- abdominal pain
- amnesia
- angioedema
- arthralgia
- asthenia
- chills
- cholestasis
- cirrhosis
- Co-Enzyme Q-10 deficiency
- confusion
- cough
- diabetes mellitus
- diarrhea
- dizziness
- dyspepsia
- dyspnea
- elevated hepatic enzymes
- eosinophilia
- erythema multiforme
- fatigue
- fever
- flushing
- headache
- hemolytic anemia
- hepatic failure
- hepatic necrosis
- hepatitis
- hyperglycemia
- immune-mediated necrotizing myopathy
- influenza
- insomnia
- jaundice
- leukopenia
- lupus-like symptoms
- malaise
- memory impairment
- musculoskeletal pain
- myalgia
- myasthenia
- myoglobinuria
- myopathy
- nausea
- pancreatitis
- paresthesias
- peripheral neuropathy
- pharyngitis
- photosensitivity
- purpura
- renal failure (unspecified)
- renal tubular obstruction
- rhabdomyolysis
- sinusitis
- Stevens-Johnson syndrome
- stroke
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vasculitis
- weakness
Monitoring Parameters
- creatine phosphokinase (CPK)
- LFTs
- serum cholesterol profile
- serum creatinine/BUN
Contraindications
- alcoholism
- breast-feeding
- children
- contraception requirements
- diabetes mellitus
- electrolyte imbalance
- endocrine disease
- females
- geriatric
- hepatic disease
- hypotension
- hypothyroidism
- infants
- infection
- myopathy
- pregnancy
- renal impairment
- rhabdomyolysis
- seizure disorder
- stroke
- surgery
- trauma
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Aliskiren
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Alogliptin; Pioglitazone
- Aluminum Hydroxide
- Aluminum Hydroxide; Magnesium Carbonate
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Aluminum Hydroxide; Magnesium Trisilicate
- Amiodarone
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Antacids
- Apalutamide
- Aprepitant, Fosaprepitant
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Boceprevir
- Bortezomib
- Bosentan
- Brigatinib
- Butabarbital
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Carbamazepine
- Carvedilol
- Ceritinib
- Cholestyramine
- Cimetidine
- Ciprofloxacin
- Clarithromycin
- Cobicistat
- Colchicine
- Colchicine; Probenecid
- Colesevelam
- Colestipol
- Conivaptan
- Conjugated Estrogens; Bazedoxifene
- Cyclosporine
- Daclatasvir
- Dalfopristin; Quinupristin
- Danazol
- Daptomycin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Digoxin
- Diltiazem
- Dronedarone
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Eltrombopag
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enzalutamide
- Erythromycin
- Erythromycin; Sulfisoxazole
- Eslicarbazepine
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etravirine
- Everolimus
- Fenofibrate
- Fenofibric Acid
- Fluconazole
- Fosamprenavir
- Gemfibrozil
- Glecaprevir; Pibrentasvir
- Glimepiride; Pioglitazone
- grapefruit juice
- Hydantoins
- Hydrochlorothiazide, HCTZ; Spironolactone
- Idelalisib
- Imatinib
- Indinavir
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Istradefylline
- Itraconazole
- Ixabepilone
- Ketoconazole
- Lanthanum Carbonate
- Lasmiditan
- Ledipasvir; Sofosbuvir
- Leflunomide
- Letermovir
- Lomitapide
- Lopinavir; Ritonavir
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Magnesium Hydroxide
- Mephobarbital
- Mestranol; Norethindrone
- Metformin; Pioglitazone
- Methohexital
- Mifepristone
- Mitotane
- Nefazodone
- Nelfinavir
- Nevirapine
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nicardipine
- Nilotinib
- Ombitasvir; Paritaprevir; Ritonavir
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Oritavancin
- Oxcarbazepine
- Pazopanib
- Pentobarbital
- Pexidartinib
- Phenobarbital
- Pioglitazone
- Posaconazole
- Primidone
- Quinine
- Raltegravir
- Ranolazine
- Red Yeast Rice
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Riluzole
- Ritonavir
- Rivaroxaban
- Sapropterin
- Saquinavir
- Sarilumab
- Secobarbital
- Segesterone Acetate; Ethinyl Estradiol
- Siltuximab
- Simeprevir
- Sirolimus
- Sodium Bicarbonate
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sorafenib
- Spironolactone
- St. John’s Wort, Hypericum perforatum
- Streptogramins
- Tacrolimus
- Talazoparib
- Telaprevir
- Telbivudine
- Telithromycin
- Telotristat Ethyl
- Temsirolimus
- Teriflunomide
- Thiopental
- Tipranavir
- Tocilizumab
- Tolvaptan
- Trandolapril; Verapamil
- Tucatinib
- Vemurafenib
- Verapamil
- Voriconazole
- Warfarin
- Zonisamide
