Ezetimibe

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Ezetrol; Belgium: Ezetrol; Bulgaria: Ezetrol; Cyprus: Ezetrol; Czech Republic: Ezetrol, Zient; Denmark: Ezetrol; Estonia: Ezetrol; Finland: Ezetrol; France: Ezetrol; Germany: Ezetimibe, Ezetrol, Viemm; Greece: Ezetimibe, Ezetrol; Hungary: Ezetrol; Ireland: Ezetrol; Italy: Ezetrol, Zetia; Latvia: Ezetrol; Lithuania: Ezetrol; Malta: Ezetrol; Netherlands: Ezetrol; Poland: Ezetrol; Portugal: Adacai, Ezetrol; Romania: Ezetrol; Slovakia: Ezetrol; Slovenia: Ezetrol, Ezoleta; Sweden: Ezetrol; UK: Ezetrol.

North America

Canada: Ezetrol; USA: Zetia.

Latin America

Argentina: Acotral, Alin, Alipas, Cerclerol, Cetrakam, Coracil, Enediex, Ezetrol, Ixacor, Nalecol, Sinterol, Trilip, Vadel, Zetia; Brazil: Zetia; Mexico: Ezetrol, Zient.

Asia

Japan: Zetia.

Drug combinations

Ezetimibe and Atorvastatin

Ezetimibe and Fenofibrate

Ezetimibe and Simvastatin

Chemistry

Ezetimibe: C~24~H~21~F~2~NO~3~. Mw: 409.43. (1) 2-Azetidinone, 1-(4-fluorophenyl)-3-[3-(4-fluorophenyl)-3-hydroxypropyl]-4-(4-hydroxyphenyl)-, [3R-[3α(S*),4β]]-; (2)(3R,4S)-1-(p-Fluorophenyl)-3-[(3S)-3-(p-fluorophenyl)-3-hydroxypropyl]-4-(p-hydroxyphenyl)-2-azetidinone. CAS-163222-33-1. (1999).

Pharmacologic Category

Antilipemic Agents; Cholesterol Absorption Inhibitors; 2-Azetidinone. (ATC-Code: C10AX09).

Mechanism of action

Inhibits absorption of cholesterol at the brush border of the small intestine via the sterol transporter, Niemann-Pick C1-Like 1 (NPC1L1). This leads to a decreased delivery of cholesterol to the liver, reduction of hepatic cholesterol stores and increased clearance of cholesterol from the blood. Decreases total cholesterol, LDL-C, APOB, and triglycerides while increasing HDL-C.

Therapeutic use

Used in combination with dietary therapy for treatment of primary hypercholesterolemia (as monotherapy or in combination with HMG-CoA reductase inhibitors). Homozygous sitosterolemia. Homozygous familial hypercholesterolemia (in combination with atorvastatin or simvastatin). Mixed hyperlipidemia (in combination with fenofibrate).

Pregnancy and lactiation implications

Use during pregnancy only if potential benefit to mother outweighs possible risk to fetus. Use not recommended during lactation.

Unlabeled use

Contraindications

Hypersensitivity to ezetimibe or any component of the formulation. Concomitant use with an HMG-CoA reductase inhibitor in active hepatic disease or unexplained persistent elevations in serum transaminases.

Warnings and precautions

Use with caution in mild hepatic impairment. Not recommended for use with moderate or severe hepatic impairment. Use with caution in severe renal impairment (CrCl <30 mL/minute). Concurrent use of fibric acid derivatives (e.g. fenofibrate, gemfibrozil) may increase the risk of cholelithiasis. Secondary causes of hyperlipidemia should be ruled out prior to therapy. Hypersensitivity reactions might occur. Transient elevations in serum aminotransferase (transaminase) concentrations reported (more frequently with ezetimibe-statin combination). Use not recommended in children <10 years of age.

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