Ezetimibe (Ezetimibe)
Also sold as: Zetia, Ezetrol, Ezet
Pregnancy
Cat C
Lactation
Unknown
Schedule
OTC
Forms
Tablet 10mg +1
Indications
- Primary hypercholesterolemia (monotherapy or with statin)
- Homozygous familial hypercholesterolemia
- Sitosterolemia
- LDL reduction adjunctive therapy
Adult Dosing
Primary hypercholesterolemia
10 mg PO once daily
Daily, long-term
With statin
10 mg + statin dose
Once daily
Homozygous FH
10 mg daily (with statin + other agents)
Long-term
Pediatric Dosing
Rare use in children; mainly for familial hypercholesterolemia
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl any level | No adjustment required |
Hepatic Adjustment
Mild-moderate: no adjustment. Severe: not recommended.
Pregnancy & Lactation
Pregnancy: Category C
Limited data; use only if clearly necessary.
Lactation: Unknown
Unknown if excreted; caution advised.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Bile acid sequestrants (cholestyramine) | Reduced ezetimibe absorption (take 2+ hours apart) | Major |
| Statins (especially simvastatin, pravastatin) | Synergistic LDL lowering; increased myopathy risk | Moderate |
| Cyclosporine | Increased ezetimibe levels (up to 16-fold) | Major |
| Fibrates | May increase GI toxicity | Minor |
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Side Effects
Common
- Myalgia
- Abdominal pain
- Diarrhea
- Fatigue
- Headache
Serious / Discontinue If
- Myopathy (especially with statin)
- Hepatotoxicity
- Angioedema (rare)
- Cholelithiasis
Contraindications
- Hypersensitivity to ezetimibe
- Active liver disease (with statin)
- Bile acid sequestrant use (separate dosing)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Zetia 10 | MSD | 10 tab ₹240 |
| Ezetrol 10 | Cipla | 10 tab ₹180 |
| Ezet 10 | Intas | 10 tab ₹160 |
Monitoring Required
- LFT if combined with statin (baseline and 12 weeks)
- Lipid panel 4-12 weeks
- Muscle symptoms
- CK if pain develops
Patient Counseling Points
- Take once daily; can be with or without food
- If also taking cholestyramine, take ezetimibe at least 2 hours before
- Report muscle pain or weakness
- Regular lipid and liver function tests
- Additive effect with statins for better LDL reduction
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Clinically reviewed by: Dr. Anil Sharma, MD (Internal Medicine), Lipidology Fellow
Last reviewed: 2026-04-13
References
- BNF — Ezetimibe
- ESC Lipid Guidelines 2023
- IDSA Hypercholesterolemia Review