Health Centres - Ezetrol
How does it work?
Ezetrol tablets contain the active ingredient ezetimibe, which is type of medicine known as a cholesterol absorption inhibitor. It is used to lower high cholesterol levels.
Ezetimibe works, as the name suggests, by preventing cholesterol from being absorbed from the small intestine into the bloodstream. It prevents cholesterol and other plant sterols that are consumed in the diet from being absorbed into the bloodstream. It also prevents cholesterol released from the bile duct into the intestine from being reabsorbed into the bloodstream. The overall result is a reduction in cholesterol levels in the blood.
Ezetimibe is used to lower cholesterol in people with high cholesterol levels (primary hypercholesterolaemia). It is normally used when another type of cholesterol-lowering medicine called a statin (for example simvastatin, atorvastatin), together with a low cholesterol diet and increased exercise, has not lowered cholesterol sufficiently. Ezetimibe is added to the statin treatment because it works in a different way to statins (which lower cholesterol by preventing its production by the liver) and so it can boost their cholesterol lowering effect.
Ezetimibe may also be used on its own to lower cholesterol in people with primary hypercholesterolaemia who cannot take statins.
Ezetimibe is used in conjunction with a statin and a cholesterol-lowering diet to lower cholesterol in people with inherited high cholesterol levels (familial hypercholesterolaemia).
Lastly, ezetimibe can be used to treat people with a rare inherited disorder called homozygous sitosterolaemia, where there are raised levels of plant sterols that are similar to cholesterol in the blood. In this case ezetimibe is used on its own, together with a cholesterol-lowering diet.
It is important to continue to follow a cholesterol-lowering diet and exercise regime while taking ezetimibe.
What is it used for?
-
High blood cholesterol levels
-
Inherited high blood cholesterol levels
- A rare inherited disease with raised levels of plant sterols similar to cholesterol in the blood (homozygous sitosterolaemia or phytosterolaemia)
Warning!
- If you are taking this medicine with a statin you should have blood tests to monitor your liver function before starting, and regularly throughout treatment.
- This medicine may rarely have side effects on the muscles. For this reason you should inform your doctor immediately if you experience any unexplained muscular symptoms, such as pain, tenderness or weakness while taking this medicine. Your doctor may need to check for side effects on the muscles by taking a blood test to measure the level of a compound called creatinine phosphokinase (CPK) in your blood.
- This medicine is not recommended for children under 10 years of age, as it has not been studied in this age group. Clinical experience in children aged 9 to 17 years is limited.
- This medicine is not recommended for people with moderate to severely decreased liver function.
Not to be used in
- Active liver disease (if taken with a statin)
- People with unexplained raised results in liver function tests (if taken with a statin)
- Pregnancy (if taken with a statin)
-
Breastfeeding
- Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine must not be used during pregnancy if it is taken with a statin. If it is not taken with a statin, it should only be used during pregnancy if considered essential by your doctor. This is because its safety during pregnancy has not yet been established. Seek medical advice from your doctor.
- It is not known if this medicine passes into breast milk. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Headache
- Abdominal pain
- Diarrhoea
- Constipation
- Excess gas in the stomach and intestines (flatulence)
- Nausea
- Fatigue
- Allergic skin rash
- Liver disorders
- Pain in the muscles or joints (myalgia or arthralgia)
- Muscle disorders (myopathy or rhabdomyolysis)
- Inflammation of the pancreas (pancreatitis)
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
If you have been prescribed cholestyramine or colestipol as well as this medicine, you should take this medicine at least two hours before, or at least four hours after taking the cholestyramine or colestipol. This is because these medicines can make ezetimibe less effective if they are taken at the same time.
This medicine is not recommended for people taking fibrate medicines to lower cholesterol, eg bezafibrate, gemfibrozil.
The immunosuppressant ciclosporin may increase the body's exposure to ezetimibe. Conversely, ezetimibe may increase the blood level of ciclosporin. The manufacturer of this medicine recommends that it should be used with caution in people taking ciclosporin and that, if the combination is used, ciclosporin blood levels should be monitored.
People who are taking an anticoagulant medicine, for example warfarin, should have their blood-clotting time (INR) monitored after they start taking this medicine, in order to check that this medicine has not affected the action of the anticoagulant.
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