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ezetimibe

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Brand names: Zetia

Cholesterol Absorption Inhibitor Rx

Ezetimibe and simvastatin is a combination medicine that helps lower cholesterol levels in your blood. It contains two drugs: ezetimibe and simvastatin.

Drug Shortage Alert

ezetimibe is currently listed as to be discontinued by the FDA. Affected manufacturer: Actavis Pharma, Inc..

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Drug Pricing (NADAC)

Brand Price

$12.66/unit

Generic Price

$0.08/unit

Generic Savings

99%

Generic Available

Yes (18 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

This medicine is used to lower high LDL cholesterol ('bad' cholesterol).

Common side effects

Headache, Upper respiratory tract infection, Muscle pain

Key warnings

This medicine can cause muscle problems, including rhabdomyolysis, which can lead to kidney damage and death.

How It Works

Ezetimibe reduces the amount of cholesterol your body absorbs from food. Simvastatin belongs to a class of drugs called statins. Statins lower cholesterol by blocking a substance your body needs to make cholesterol.

How to Take It

Take ezetimibe and simvastatin once a day in the evening. You can take it with or without food. The usual dose is 10 mg/10 mg to 10 mg/40 mg daily. Your doctor may adjust your dose based on your cholesterol levels.

Pregnancy & Breastfeeding

Do not take ezetimibe and simvastatin if you are pregnant. It can harm your unborn baby. Talk to your doctor about other ways to lower your cholesterol if you are pregnant or planning to become pregnant. Breastfeeding is not recommended while taking this medicine.

Missed Dose

If you miss a dose, take it as soon as you remember. Do not double your next dose.

Storage

Store at room temperature, away from light and moisture. Keep the container tightly closed.

Side Effects (from patient reports)

Based on 35,601 FDA adverse event reports.

Tiredness
4,662
Feeling sick to your stomach
4,195
Muscle pain
4,191
Diarrhea
3,661
Medicine not working
3,517
Feeling lightheaded
3,337
Shortness of breath
3,257
Headache
3,149
Joint pain
2,849
Weakness
2,783

FDA Adverse Event Report Analysis

Detailed analysis of 70,203 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.

Total Reports

70,203

Death-Related Reports

4,102

Hospitalization Reports

20,751

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 34,208 (53%)
Male 30,015 (46%)

Age Distribution

0–17 256
18–44 2,117
45–64 16,335
65–74 15,918
75+ 12,165

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 FATIGUE 4,663
2 NAUSEA 4,195
3 MYALGIA 4,191
4 DIARRHOEA 3,662
5 DRUG INEFFECTIVE 3,517
6 DIZZINESS 3,338
7 DYSPNOEA 3,257
8 HEADACHE 3,149
9 ARTHRALGIA 2,850
10 ASTHENIA 2,785
11 PAIN 2,754
12 PAIN IN EXTREMITY 2,318
13 FALL 2,309
14 VOMITING 2,245
15 OFF LABEL USE 2,213

Reactions in Death Reports

DEATH 1,211
DYSPNOEA 386
SEPSIS 368
FALL 339
DIARRHOEA 331
ASTHENIA 322
CARDIO-RESPIRATORY ARREST 322
FATIGUE 315
ABDOMINAL PAIN 285
HAEMORRHAGIC STROKE 281

Reactions in Hospitalization Reports

NAUSEA 1,361
DYSPNOEA 1,315
FALL 1,272
FATIGUE 1,243
PNEUMONIA 1,172
ASTHENIA 1,117
ACUTE KIDNEY INJURY 1,115
DIARRHOEA 1,058
VOMITING 1,015
DIZZINESS 981

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

This medicine can cause muscle problems, including rhabdomyolysis, which can lead to kidney damage and death. The risk is higher if you are over 65, have kidney problems, have thyroid problems, or take certain other medicines. Tell your doctor right away if you have unexplained muscle pain, tenderness, or weakness, especially if you also have a fever or feel sick. This medicine can also cause liver problems. Your doctor may do blood tests to check your liver before and during treatment.

Known Drug Interactions

For patients taking amiodarone, amlodipine, or ranolazine, do not exceed ezetimibe and simvastatin 10 mg/20 mg daily [see Dosage and Administration ( 2.3 )].

Mechanism: Amlodipine can increase the levels of the cholesterol medicine in your blood, which may lead to side effects.

What to do: Your doctor should limit your dose of the combination medicine to 10 mg/20 mg daily.

Intervention: For patients taking verapamil, diltiazem, or dronedarone, do not exceed ezetimibe and simvastatin 10 mg/10 mg daily.

Mechanism: Diltiazem can increase the levels of the cholesterol medicine in your blood, which may lead to muscle problems.

What to do: Your doctor should limit your dose of the combination medicine to 10 mg/10 mg daily.

Intervention: For patients taking verapamil, diltiazem, or dronedarone, do not exceed ezetimibe and simvastatin 10 mg/10 mg daily.

Mechanism: Verapamil can cause the levels of the cholesterol medicine to build up in your body, which may lead to muscle damage.

What to do: Your doctor should limit your dose of the combination medicine to 10 mg/10 mg daily.

Cyclosporine, Danazol, or Gemfibrozil Clinical Impact: The risk of myopathy and rhabdomyolysis is increased with concomitant use of cyclosporine, danazol, or gemfibrozil with ezetimibe and simvastatin. Intervention: Concomitant use of cyclosporine, danazol, or gemfibrozil with ezetimibe and simvastatin is contraindicated [see Contraindications ( 4 )].

Mechanism: Taking these medicines together greatly increases the risk of serious muscle breakdown and damage.

What to do: Do not use these medications together.

Amiodarone, Dronedarone, Ranolazine, or Calcium Channel Blockers Clinical Impact: The risk of myopathy and rhabdomyolysis is increased by concomitant use of amiodarone, dronedarone, ranolazine, or calcium channel blockers with ezetimibe and simvastatin. For patients taking amiodarone, amlodipine, or ranolazine, do not exceed ezetimibe and simvastatin 10 mg/20 mg daily [see Dosage and Administration ( 2.3 )].

Mechanism: Taking these drugs together can cause the cholesterol medicine to build up in your body, which increases the risk of serious muscle damage.

What to do: Your doctor should limit your dose of ezetimibe and simvastatin to no more than 10 mg/20 mg daily.

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Common Questions

Can I take this medicine if I have liver problems?
You should not take this medicine if you have acute liver failure or decompensated cirrhosis.
What should I do if I experience muscle pain while taking this medicine?
Tell your doctor right away if you have unexplained muscle pain, tenderness, or weakness, especially if you also have a fever or feel sick.
Can I drink grapefruit juice while taking this medicine?
Talk to your doctor before drinking grapefruit juice while taking this medicine. Grapefruit juice can increase the amount of simvastatin in your blood, which can increase your risk of side effects.
Are there any medicines I should not take with ezetimibe and simvastatin?
You should not take this medicine with strong CYP3A4 inhibitors, cyclosporine, danazol, or gemfibrozil. Talk to your doctor about all the medicines you take.
How often will my doctor check my cholesterol levels?
Your doctor will check your LDL-C levels as early as 2 weeks after starting this medicine, and adjust the dosage if needed.
Can children take ezetimibe and simvastatin?
Yes, ezetimibe and simvastatin can be used in children 10 years and older with heterozygous familial hypercholesterolemia (HeFH).
What is the highest dose of ezetimibe and simvastatin I can take?
The maximum recommended dosage is ezetimibe and simvastatin 10 mg/40 mg once daily.
What if I need a high-intensity statin?
If you require a high-intensity statin or cannot reach your LDL-C goal with ezetimibe and simvastatin 10 mg/40 mg daily, your doctor will prescribe alternative LDL-C-lowering treatment.
What should I do before starting ezetimibe and simvastatin?
Consider testing your liver enzymes before starting therapy and as clinically indicated thereafter.
What if I have kidney problems?
If you have moderate to severe kidney problems, doses exceeding 10 mg/20 mg should be used with caution and close monitoring.
What are the common side effects of ezetimibe?
The most commonly reported side effects of ezetimibe include Headache, Upper respiratory tract infection, Muscle pain, Diarrhea. Based on 35,601 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does ezetimibe interact with other medications?
Yes, ezetimibe has 25 known drug interactions. Notable interactions include amlodipine, diltiazem, verapamil. Always inform your doctor about all medications you are taking.
What drug class is ezetimibe?
ezetimibe belongs to the Cholesterol Absorption Inhibitor drug class. It requires a prescription (Rx). This medicine is used to lower high LDL cholesterol ('bad' cholesterol).
Is there a generic version of ezetimibe?
Yes, generic ezetimibe is available from 18 manufacturers. The generic costs $0.08 per unit compared to $12.66 for the brand version, saving approximately 99%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is ezetimibe safe during pregnancy?
Do not take ezetimibe and simvastatin if you are pregnant. It can harm your unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Is ezetimibe currently in shortage?
Yes, ezetimibe is currently listed as to be discontinued by the FDA. Affected manufacturer: Actavis Pharma, Inc.. Visit the FDA Drug Shortages database for the latest updates.

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What the FDA Data Shows for ezetimibe

The FDA label for ezetimibe (sold under brand names such as Zetia) classifies it as a prescription-only medication in the Cholesterol Absorption Inhibitor class. This medicine is used to lower high LDL cholesterol ('bad' cholesterol). Official labeling lists 4 commonly reported side effects, including Headache, Upper respiratory tract infection, Muscle pain.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 35,601 voluntary reports. The database also lists 25 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.08 versus $12.66 for the brand — a 99% generic savings.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: April 14, 2024

All federal data sources used on this page