ezetimibe and simvastatin

What is the most important information I should know about ezetimibe and simvastatin?

Do not use ezetimibe and simvastatin if you are pregnant or breastfeeding.

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.

What is ezetimibe and simvastatin?

Ezetimibe reduces the amount of cholesterol absorbed by the body. Simvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins."

Ezetimibe and simvastatin is a combination medicine that is used to lower blood levels of "bad" cholesterol (low-density lipoprotein, or LDL), to increase levels of "good" cholesterol (high-density lipoprotein, or HDL), and to lower triglycerides (a type of fat in the blood).

Ezetimibe and simvastatin is used together with a low-fat diet and other treatments to lower total cholesterol in adults and children who are at least 10 years old. It is not known whether this medicine reduces your risk of heart disease.

Ezetimibe and simvastatin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking ezetimibe and simvastatin?

• active liver disease; or
• abnormal liver function tests.

Ezetimibe and simvastatin can cause the breakdown of muscle tissue, which can lead to kidney failure. This happens more often in women, in older adults, in people of Chinese descent, and in people who have kidney disease or poorly controlled hypothyroidism (underactive thyroid).

• cyclosporine;
• danazol;
• gemfibrozil;
• nefazodone;
• an antibiotic --clarithromycin, erythromycin, telithromycin;
• antifungal medication --itraconazole, ketoconazole, posaconazole, voriconazole;
• hepatitis C medications --boceprevir, telaprevir; or
• HIV/AIDS medication --atazanavir, cobicistat, indinavir, nelfinavir, ritonavir, saquinavir, tipranavir.

Your doses of certain other medicines may need to be adjusted while you are taking ezetimibe and simvastatin. This includes:

• amiodarone or dronedarone;
• amlodipine (sometimes in combination medicines--Azor, Caduet, Consensi, Exforge, Lotrel, Prestalia, Twynsta, Tribenzor);
• colchicine;
• diltiazem, verapamil;
• fenofibrate, fenofibric acid;
• lomitapide;
• ranolazine; or
• medicines that contain niacin, nicotinic acid, or vitamin B3, such as Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others.

Tell your doctor if you have ever had:

• unexplained weakness or muscle pain;
• a thyroid disorder;
• liver or kidney disease;
• liver problems caused by alcohol;
• a habit of drinking more than 2 alcoholic drinks per day; or
• if you are older than 65.

This medicine should not be given to a girl who has not yet had menstrual periods.

How should I take ezetimibe and simvastatin?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take this medicine in the evening, with or without food.

You will need frequent medical tests.

Ezetimibe and simvastatin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your doctor's instructions very closely.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

What should I avoid while taking ezetimibe and simvastatin?

Grapefruit may interact with ezetimibe and simvastatin and lead to unwanted side effects. Avoid the use of grapefruit products.

Avoid eating foods high in fat or cholesterol, or ezetimibe and simvastatin will not be as effective.

What are the possible side effects of ezetimibe and simvastatin?

• unexplained muscle pain, tenderness, or weakness;
• muscle weakness in your hips, shoulders, neck, and back;
• trouble lifting your arms, trouble climbing or standing;
• fever, unusual tiredness;
• upper stomach pain, loss of appetite;
• dark colored urine; or
• jaundice (yellowing of the skin or eyes).

Common side effects may include:

• headache;
• muscle pain;
• abnormal liver function tests;
• diarrhea; or
• cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ezetimibe and simvastatin?

If you also take cholestyramine, colesevelam, or colestipol: Take your ezetimibe and simvastatin dose 2 hours before or 4 hours after you take the other medicine.

Tell your doctor about all your current medicines. Many drugs can affect ezetimibe and simvastatin, especially:

• a blood thinner such as warfarin, Coumadin, or Jantoven; or
• heart or blood pressure medication.

This list is not complete and many other drugs may affect ezetimibe and simvastatin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about ezetimibe and simvastatin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2023 Cerner Multum, Inc. Version: 11.01. Revision date: 10/1/2020.