Ezetimibe Simvastatin Brand Name– Vytorin
What is Ezetimibe Simvastatin
Ezetimibe simvastatin (Vytorin) is an oral antilipemic combination. Ezetimibe is a potent cholesterol absorption inhibitor and selectively blocks the intestinal absorption of cholesterol and related phytosterols.
Simvastatin is an HMG-CoA reductase inhibitor (‘statin’). The combination of ezetimibe with a statin results in synergistic cholesterol-lowering effects.
Vytorin (ezetimibe 10 mg combined with simvastatin 10 to 80 mg) reduces LDL-cholesterol by approximately 45—60% compared to LDL reduction ranges of 33—49% achieved by simvastatin monotherapy (10—80 mg/day) and 36—53% attained by atorvastatin (10—80 mg/day), respectively, during comparative clinical trials
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 (e.g., LDL apheresis) or if such treatments are unavailable
Side Effects
- abdominal pain
- alopecia
- amnesia
- anaphylactoid reactions
- anemia
- angioedema
- arthralgia
- asthenia
- atrial fibrillation
- back pain
- cataracts
- chills
- cholecystitis
- cholelithiasis
- cholestasis
- cirrhosis
- Co-Enzyme Q-10 deficiency
- confusion
- constipation
- cough
- depression
- diabetes mellitus
- diarrhea
- dizziness
- dyspepsia
- dyspnea
- edema
- elevated hepatic enzymes
- eosinophilia
- erythema multiforme
- fatigue
- fever
- flatulence
- flushing
- gastritis
- headache
- hemolytic anemia
- hepatic failure
- hepatic necrosis
- hepatitis
- hyperbilirubinemia
- hyperglycemia
- immune-mediated necrotizing myopathy
- impotence (erectile dysfunction)
- infection
- influenza
- insomnia
- interstitial lung disease
- jaundice
- leukopenia
- lupus-like symptoms
- malaise
- memory impairment
- musculoskeletal pain
- myalgia
- myasthenia
- myoglobinuria
- myopathy
- nausea
- pancreatitis
- paresthesias
- peripheral neuropathy
- pharyngitis
- photosensitivity
- pruritus
- purpura
- rash
- renal tubular obstruction
- rhabdomyolysis
- sinusitis
- Stevens-Johnson syndrome
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vasculitis
- vertigo
- vomiting
- weakness
Monitoring Parameters
- creatine phosphokinase (CPK)
- LFTs
- serum cholesterol profile
- serum creatinine/BUN
Contraindications
- alcoholism
- Asian patients
- breast-feeding
- children
- cholestasis
- contraception requirements
- diabetes mellitus
- electrolyte imbalance
- endocrine disease
- females
- geriatric
- hepatic disease
- hepatic encephalopathy
- hepatitis
- hypotension
- hypothyroidism
- infants
- infection
- jaundice
- myopathy
- neonates
- organ transplant
- pregnancy
- renal disease
- renal failure
- renal impairment
- rhabdomyolysis
- seizure disorder
- surgery
- trauma
Interactions
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Amiodarone
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Antacids
- Aprepitant, Fosaprepitant
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Atazanavir
- Atazanavir; Cobicistat
- Barbiturates
- Bempedoic Acid
- Bempedoic Acid; Ezetimibe
- Boceprevir
- Bortezomib
- Bosentan
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Carbamazepine
- Ceritinib
- Chlorzoxazone
- Cholestyramine
- Cimetidine
- Ciprofloxacin
- Clarithromycin
- Cobicistat
- Colchicine
- Colchicine; Probenecid
- Colesevelam
- Colestipol
- Conivaptan
- Crizotinib
- Cyclosporine
- Dabigatran
- Dabrafenib
- Daclatasvir
- Danazol
- Daptomycin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deferasirox
- Delavirdine
- Digoxin
- Diltiazem
- Dronedarone
- Duvelisib
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Eltrombopag
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Encorafenib
- Erythromycin
- Erythromycin; Sulfisoxazole
- Eslicarbazepine
- Etravirine
- Everolimus
- Fedratinib
- Fenofibrate
- Fenofibric Acid
- Flibanserin
- Fluconazole
- Fluvoxamine
- Fosamprenavir
- Fostamatinib
- Fostemsavir
- Gemfibrozil
- Glecaprevir; Pibrentasvir
- grapefruit juice
- Hydantoins
- Hydrochlorothiazide, HCTZ; Propranolol
- Idelalisib
- Imatinib
- Indinavir
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivacaftor
- Ivosidenib
- Ketoconazole
- Lanthanum Carbonate
- Lefamulin
- Leflunomide
- Letermovir
- Lomitapide
- Lopinavir; Ritonavir
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Metformin; Repaglinide
- Mifepristone
- Mitotane
- Nefazodone
- Nelfinavir
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nicardipine
- Obeticholic Acid
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Oxcarbazepine
- Pazopanib
- Perindopril; Amlodipine
- Pexidartinib
- Posaconazole
- Propranolol
- Protease inhibitors
- Quinine
- Raltegravir
- Ranolazine
- Red Yeast Rice
- Repaglinide
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Riluzole
- Ritonavir
- Saquinavir
- Sarilumab
- Siltuximab
- Simeprevir
- Sirolimus
- Sodium Bicarbonate
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- St. John’s Wort, Hypericum perforatum
- Tacrolimus
- Telaprevir
- Telbivudine
- Telithromycin
- Teriflunomide
- Tesamorelin
- Tezacaftor; Ivacaftor
- Ticagrelor
- Tipranavir
- Tocilizumab
- Tolvaptan
- Trandolapril; Verapamil
- Tucatinib
- Verapamil
- Voriconazole
- Warfarin
- Zafirlukast
