1. About ezetimibe
Ezetimibe is a type of medicine used to lower cholesterol.
It's used to treat high blood cholesterol. This is when you have too much of a fatty substance called cholesterol in your blood.
You may also be prescribed ezetimibe if you cannot take cholesterol-lowering medicines called statins, or if statins do not work for you.
Ezetimibe is available on prescription only. It comes as tablets.
Ezetimibe also comes mixed with simvastatin, a type of statin. This is known by the brand name Inegy.
2. Key facts
- Ezetimibe helps stop your body taking in cholesterol from food.
- It usually lowers cholesterol levels within 2 weeks.
- You can take this medicine with or without food.
- Common side effects include stomach (abdominal) pain and diarrhoea.
- Ezetimibe is also known by the brand name Ezetrol. It can also be mixed with simvastatin, a type of statin. This is known by the brand name Inegy.
3. Who can and cannot take ezetimibe
Ezetimibe can be taken by adults and children from the age of 10 years.
Ezetimibe is not suitable for some people. To make sure it is safe for you, tell your doctor if you:
- have had an allergic reaction to ezetimibe or any other medicines in the past
- have liver problems
- are pregnant, planning to become pregnant or are breastfeeding
4. How and when to take it
You can take ezetimibe with or without food.
The dose for adults and children is one 10mg tablet, taken once a day.
What if I forget to take it?
If you forget to take ezetimibe, take it as soon as you remember. If you do not remember until the following day, skip the missed dose and take your next one at the usual time.
Do not take a double dose to make up for a forgotten dose. If you often forget doses, it may help to set an alarm to remind you.
You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.
What if I take too much?
Taking 1 or 2 extra tablets is unlikely to harm you. But the amount of ezetimibe that can lead to overdose is different from person to person.
If you need to go to A&E, do not drive yourself – get someone else to drive you.
Take the ezetimibe packet, or the leaflet inside it, plus any remaining medicine with you.
5. Side effects
Like all medicines, ezetimibe can cause side effects in some people, although not everyone gets them.
Common side effects
These common side effects may happen in more than 1 in 100 people.
Keep taking the medicine, but talk to a doctor if these side effects bother you or do not go away:
- stomach (abdominal) pain
- farting more than usual
- feeling more tired than usual
Serious side effects
Serious side effects are not common and happen in less than 1 in 10,000 people.
Tell a doctor straight away if you get:
- muscle pain, tenderness, weakness or cramps
- yellow skin or the whites of your eyes turn yellow, pale poo and dark pee – this can be a sign of liver problems
- severe stomach pain (just under your ribs) – this can be a symptom of pancreas problems
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to ezetimibe.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of ezetimibe. For a full list, see the leaflet inside your medicine packet.
You can report any suspected side effect to the UK safety scheme.
6. How to cope with side effects
What to do about:
- stomach (abdominal) pain – try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you're in a lot of pain, speak to a pharmacist or doctor.
- diarrhoea – drink lots of fluids, such as water or squash, to avoid dehydration. Speak to a pharmacist if you have signs of dehydration such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. Speak to a doctor if diarrhoea lasts for more than a week after you start ezetimibe.
- farting – try to not eat foods that cause wind (such as lentils, peas, beans and onions). Eat smaller meals, eat and drink slowly, and exercise regularly. There are pharmacy medicines that may also help, such as charcoal tablets or simeticone. Peppermint tea may also help.
- feeling tired – try to relax when possible and avoid intense exercise to see if that helps. If these symptoms do not go away after 1 to 2 weeks, ask a pharmacist or doctor for advice.
7. Pregnancy and breastfeeding
Ezetimibe is not usually recommended during pregnancy or while breastfeeding. This is because there is very little information about its safety.
A doctor may suggest another medicine for lowering cholesterol, such as colestyramine.
Non-urgent advice: Speak to a doctor if you're:
- trying to get pregnant
8. Cautions with other medicines
Some medicines can affect the way ezetimibe tablets work. They may also make your more likely to get side effects.
Tell a doctor if you're taking these medicines before you start ezetimibe:
- ciclosporin, a medicine used to treat psoriasis or after an organ transplant
- medicines used to prevent blood clots, such as warfarin
- other medicines used for lowering cholesterol (this does not include statins), such as colestyramine or bezafibrate
Mixing ezetimibe with herbal remedies and supplements
There's very little information about taking herbal medicines and supplements with ezetimibe.
9. Common questions
How long does it take to work?
If you take your medicine as prescribed, your cholesterol levels should drop within 2 weeks.
How long will I take it for?
Usually, treatment with ezetimibe is for life. You will need to keep taking it for it to work.
Do not stop taking your medicine without speaking to a doctor first.
What happens if I stop taking it?
If you stop taking ezetimibe without starting a different treatment, your cholesterol levels may go up again.
Talk to a doctor if you are thinking about stopping this medicine.
How does it compare with similar medicines?
There are other types of medicines that can help lower cholesterol.
Statins are the most commonly prescribed medicines. A doctor may decide to prescribe ezetimibe together with a statin. Statins include:
Other cholesterol-lowering medicines include bezafibrate (and other fibrates) and colestyramine. These are usually prescribed by a specialist.
Can I drink alcohol with it?
Yes, you can drink alcohol while taking ezetimibe.
Is there any food or drink I should avoid?
You can eat and drink normally while taking ezetimibe.
Will ezetimibe affect my contraception?
But if you get severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy.
Will it affect my fertility?
There's no firm evidence to suggest that taking ezetimibe will affect fertility in either men or women.
Can I drive or ride a bike?
Yes, you can drive or ride a bike while taking ezetimibe.
Can lifestyle changes help lower my cholesterol?
Usually, treatment with ezetimibe is for life.
Ezetimibe will work best if you can reduce your cholesterol as this will also reduce your risk of heart disease.
There are lifestyle changes you can make that will help lower your cholesterol:
- make sure you're a healthy weight
- eat a healthy, well balanced diet – reduce saturated fat and increase fibre, fruits, vegetables, wholegrains and fish
- quit smoking
- cut down on alcohol
- try to exercise every day