Ezetimibe (Zetia): For High Cholesterol
Ezetimibe (brand name Zetia) is a medication used to treat high cholesterol. It is usually used when you have not been successful in trying to control your cholesterol with a healthy diet and a 'statin' (the go-to medication for high-cholesterol).
What is Cholesterol and Why is it Bad?
Cholesterol itself isn’t bad! “Cholesterol” is a fat-like substance that flows through our blood. It is necessary for our bodies to function in a healthy way.
However, when you eat too many fatty foods over a long period of time, your body gets more cholesterol than it needs for everyday functions. With nowhere else to go, the cholesterol will start sticking to the walls of your blood vessels. Over time, this can cause lots of problems, which is why there are medications to help.
How Do I Know if I Have High Cholesterol?
Unlike many illnesses, for high cholesterol, there aren’t many symptoms to look out for. Your healthcare provider will usually want to test you for high cholesterol when you have known “risk factors”. These include:
- Being overweight
- Having a family history of high cholesterol or heart disease
- Having an inactive lifestyle
- Eating an unhealthy, high fat, diet
- Currently or having a history of smoking cigarettes
- Having diabetes
If you have some of those risk factors, your healthcare provider will do a blood test to see if you have too much cholesterol. This test looks for three different kinds of cholesterol: high-density lipoprotein (HDL) low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL). LDL and VLDL cholesterol are often called the “bad” cholesterols because they bring more cholesterol into your blood. HDL cholesterol is also known as “good” cholesterol and having high levels in the blood is actually beneficial! This is because HDL cholesterol takes cholesterol away from the blood and gets rid of it.
Treatments for High Cholesterol
The first step is to get you to eat a healthy diet and do more exercise. Foods like milk, eggs, cheese, meat, and fish are good for you in small amounts, but have lots of cholesterol. Including more low cholesterol foods, such as fruits, vegetables, and grains into your diet is a great way to start lowering your cholesterol levels.
If a healthy diet is not lowering your cholesterol levels enough, the next step is for your healthcare provider to prescribe you a medication. The first medication that you will try is a 'statin', such as pitavastatin, atorvastatin, rosuvastatin, or simvastatin. These drugs work by decreasing the amount of cholesterol that your body makes.
If, after a couple months, your levels are still too high, your healthcare provider may prescribe ezetimibe in addition to the statin for more cholesterol control. This blog gives you more information on combination therapy for better cholesterol lowering results.
How Does Ezetimibe Work?
Ezetimibe works by stopping your body from absorbing the cholesterol in your small intestine. With less cholesterol being absorbed, there is less circulating in your blood. When taken in addition to statins, you are now both decreasing the amount of cholesterol your body makes (statins) and decreasing the amount you’re getting from food (ezetimibe).
What to Expect When You Start Taking Ezetimibe:
The typical dose of ezetimibe is one 10 mg tablet taken by mouth once daily. It is best to take the dose at roughly the same time each day, and it can be taken with or without food. It should start working to lower your cholesterol levels within approximately 2 weeks.
What if I Miss a Dose?
If you forget to take your daily dose of ezetimibe, you should take it as soon as you remember. However, if it is close to the time when you will be taking your next dose, just skip your missed dose; do not take two pills at one time if you forget a dose.
Most Common Side Effects of Ezetimibe
Like most drugs, ezetimibe has some potential side effects. The most common ones include:
- Feeling slightly tired or weak
- Joint pain
- Cold and flu-like symptoms
Who Should Not Take Ezetimibe?
If you are pregnant or breastfeeding, you shouldn’t take ezetimibe. There are a few medications that can’t be taken at the same time as ezetimibe. Those include:
- Fibrates (other than fenofibrate)
If you have any other health conditions, you should speak with your healthcare provider about whether or not it is okay to take ezetimibe with those conditions.
Watch the video '7 things to know about Ezetimibe (generic name Zetia®)' in which Dee, one of our registered pharmacists, answers most common questions about Ezetimibe.
1) Lexicomp: Evidence-Based Drug Information (http://online.lexi.com). Accessed 2022-06-17.
2) What's Cholesterol? (for Kids) - Nemours KidsHealth. (http://kidshealth.org). Accessed 2022-06-16.