<h3>Help Your Patients Get More LDL-C Lowering</h3><p>When additional LDL-C lowering is needed, consider complementary mechanisms.<br><br>Get Ezetimibe at no extra cost with ZYPITAMAG, only through Marley Drug. <br><br><strong>Tell your patient to mention ZYPDUO or enter coupon code ZYPDUO when placing an online order.</strong></p>

ZYPITAMAG® + Ezetimibe

No extra cost to add Ezetimibe to ZYPITAMAG

Same prescription, same duration

Available only through Marley Drug

Ezetimibe at no extra cost

<h3><strong>Statin Mechanism:</strong></h3><p>ZYPITAMAG inhibits HMG-CoA reductase, reducing hepatic cholesterol synthesis.</p>

ZYPITAMAG

<h3>Absorption mechanism:</h3><p>Ezetimibe inhibits intestinal cholesterol absorption via NPC1L1.</p>

Ezetimibe

<h3><strong>Greater LDL-C reduction:</strong></h3><p>Combination therapy lowered LDL-C more than pitavastatin monotherapy in a Phase III trial.<sup>1</sup></p>
<P><sup>1</sup>Tsujita K., et al. J Atheroscler Thromb. 2023;30(11):1580-1600.</P>

Greater LDL-C reduction:

Prescribe ZYPITAMAG 2 mg or 4 mg based on the patient’s individual treatment needs.

Select the appropriate ZYPITAMAG dose

<p>Send ZYPITAMAG and Ezetimibe together, with the same treatment duration.</p>

Include Ezetimibe on the same prescription

<p>Prescriptions must be sent to Marley Drug for the Ezetimibe Rx to be processed at no extra cost.</p>

Send the prescription to Marley Drug

How to Prescribe ZYPITAMAG + Ezetimibe to Marley Drug

<strong>Important: Send the ZYPITAMAG and Ezetimibe prescriptions to Marley Drug at the same time and for the same duration. Prescriptions submitted separately may not be honored and may require additional processing time.</strong>
<BR><BR>

Most commonly asked questions about ZYPITAMAG

<p>Statins&nbsp;are the most <a href="https://www.marleydrug.com/blog/statin-use-way-up-pitavastatin-introduced-to-the-u-s-as-a-next-generation-statin" rel="noopener noreferrer" target="_blank">widely prescribed medication</a> in the U.S. today. You may have been prescribed a statin if your doctor told you that you have <a href="https://www.marleydrug.com/blog/cholesterol-what-it-is-and-why-you-should-care" rel="noopener noreferrer" target="_blank">high cholesterol</a>. These drugs have been around for decades, and are well known as first-line therapy for the management of high cholesterol, particularly, low-density lipoprotein cholesterol (LDL-C), or ‘bad cholesterol.</p><p>Statins, while taken by millions of Americans each year, are not without their risk of side effects. The most commonly reported&nbsp;<a href="https://www.marleydrug.com/blog/statin-muscle-pain-is-more-common-then-you-think-will-switching-statins-help" rel="noopener noreferrer" target="_blank">side effects for statin</a>&nbsp;medication are various forms of muscle pain, muscle cramps, and/or muscle weakness. In real-world practice, statin side effects have been reported up to 20% of the time.</p><h4>What causes statin muscle pain?</h4><p>Statin <a href="https://www.marleydrug.com/blog/statin-symptoms-could-they-be-in-your-head" rel="noopener noreferrer" target="_blank">side effects are not well understood</a>. What we do know is that the risk of statin side effects increases as the dose of the statin increases. As a rule of thumb, the higher the dose of statin you take, the higher the concentration of statin in your blood. This leads to a higher risk of side effects such as muscle pain.</p><p>The concentration of statin medication circulating in your blood depends on quite a few factors, including:</p><ul><li><strong>Other medications you are taking:&nbsp;</strong><a href="https://www.marleydrug.com/compare-statins" rel="noopener noreferrer" target="_blank">Statins </a>can interact with other medications. Be sure to tell your doctor about any and all over-the-counter products, supplements, and prescription medications you are currently taking.</li><li><strong>The time of day you take your statin</strong>: Some statins need to be taken in the evening. This is because the cholesterol-making enzyme in our body is more active at night. Because some statins are removed from our bodies very quickly, you may need to take your statin in the evening to ensure the best results. Newer statins, like pitavastatin, tend to be more stable in our bodies and as a result, can be taken at any time of the day.</li><li><strong>Taking a statin with or without food:</strong>&nbsp;Food intake can change the availability of statins. Some statins need to be taken with a meal, whereas others should be taken on an empty stomach. Pitavastatin can be taken with or without food.</li></ul><h4>Why do statins interact with the food we consume?</h4><p>One of the first lessons they teach doctors in medical school is that drugs can interact with other drugs as well as foods and nutritional supplements. <a href="https://www.marleydrug.com/blog/do-drug-interactions-cause-statin-side-effects" rel="noopener noreferrer" target="_blank">Drug interactions</a> are something doctors want to avoid for their patients, as they can increase the risk of side effects.</p><p><em>A notable interaction most people don’t think about is grapefruit juice. So why is this a problem for some statins?</em></p><p>Well, the problem occurs when someone drinks grapefruit juice in combination with some of the first-generation statins. What this does is block the CYP3A4 enzyme in your liver, preventing your body from processing the statin in the normal way. This results in a very large increase in the concentration of statin in your blood, and as alluded to earlier, too much statin in your blood increases your risk of side effects.</p><h4>Newer Statin Medications Are Available</h4><p>The good news is that there are now newer statins available in the U.S., including <a href="https://patient.zypitamag.com/" rel="noopener noreferrer" target="_blank">Zypitamag (pitavastatin)</a>. Zypitamag is a third-generation statin. It’s unique in that it bypasses the common pathways used by the liver for statin metabolism.&nbsp;This means it won’t interact with grapefruit juice and has a reduced potential to interact with other medications you may also be taking!</p><p>Zypitamag has been shown to reduce LDL-C, or ‘bad cholesterol’ by 45%. It should be taken once daily, with or without food, at the same time each day.</p><h4>Marley Drug offers branded Zypitamag (pitavastatin) for just $1.15 a day</h4><p><em>You can access Zypitamag (pitavastatin) for $1.15 per day</em><sup><em>*</em></sup><em> without any insurance hassles through our partner Marley Drug. This price is 50% lower than at other pharmacies in the U.S</em><sup><em>*</em></sup><em>!</em></p><p><em>Additional Benefits of ordering through Marley Drug:</em></p><ul><li><em>No insurance is needed</em></li><li><em>Free Shipping Nationwide</em></li><li><em>Available to all patients*</em></li><li><em>Plus – receive the first 30 days FREE with a valid Rx*!</em></li></ul><p>Learn more about this great offer and how you can get <a href="https://www.marleydrug.com/zypitamag" rel="noopener noreferrer" target="_blank">Zypitamag for $1.15 per day</a>.</p><h6>* Conditions may apply. Visit <a href="https://patient.zypitamag.com/one-dollar-per-day" rel="noopener noreferrer" target="_blank">www.zypitamag.com</a>&nbsp;for more information. </h6><p><br></p>

Statins are the most widely prescribed medication in the U.S. today. You may have been prescribed a statin if your doctor told you that you have high cholesterol. These drugs have been around for decades, and are well known as a first-line…

Learn about how statins can interact with certain foods you take, like grapefruit juice, and can cause unwanted drug interactions and statin side effects.

Certain Foods Can Increase Your Risk of Statin Side Effects

Cholesterol

Heart Health

Foods that increase your risk of statin side effects

<p>A vast majority of the U.S population suffers from <a href="https://www.marleydrug.com/high-cholesterol" rel="noopener noreferrer" target="_blank">high cholesterol</a>. Unlike most other diseases, high cholesterol frequently presents with no symptoms and can be considered a silent killer. Today, over 70 million adult Americans have high cholesterol, yet only 1 in 3 actually have the condition under control.</p><h4><strong>What are statins?</strong></h4><p>Statins are the first line of defense against <a href="https://www.marleydrug.com/blog/cholesterol-what-it-is-and-why-you-should-care" rel="noopener noreferrer" target="_blank">high cholesterol</a> and have been around for decades. The first statin, lovastatin, was approved in the United States over 30 years ago on September 1st, 1987. Since then, statin use has increased steadily over the years, and today they are one of the most widely prescribed medications in the U.S. In fact, nearly 1 in 4 adults over 40 years of age are taking a <a href="https://www.marleydrug.com/compare-statins" rel="noopener noreferrer" target="_blank">statin</a>.</p><p>The most commonly used statin in the U.S right now is atorvastatin, which was approved in 1996. While the majority of statins currently available are several decades old, there are newer statin options available. Pitavastatin was <a href="https://www.marleydrug.com/blog/statin-use-way-up-pitavastatin-introduced-to-the-u-s-as-a-next-generation-statin" rel="noopener noreferrer" target="_blank">introduced to the U.S. in 2009</a> and is the most recently approved type of statin. Pitavastatin is different than most statins—<strong>let’s discuss how!</strong></p><h4><strong>What are drug interactions?</strong></h4><p>Drug interactions don’t typically refer to drugs directly interacting with other drugs. Instead, drugs, supplements, or <a href="https://www.marleydrug.com/blog/foods-that-increase-your-risk-of-statin-side-effects" rel="noopener noreferrer" target="_blank">foods can interact</a> with each other indirectly by stimulating or inhibiting different enzymatic processes in our bodies. Under certain circumstances, this can lead to unintended interactions.</p><p>Statins, like atorvastatin, are metabolized in our liver by an enzyme called cytochrome P450 (CYP450). This enzyme helps to break down the statin and remove it from our body after it has done its job of lowering cholesterol. Unfortunately, 70-80% of medications are also processed by the same family of enzymes. When these enzyme pathways become too busy it can lead to drug interactions.</p><p>Newer statins like pitavastatin are different than most statins and are not processed by these same enzymes. Therefore, there is less potential for certain interactions.</p><h4><strong>Do drug interactions cause statin side effects?</strong></h4><p><strong>The short answer is yes, they can.</strong></p><p>In most cases, your doctor or pharmacist should be able to predict when these interactions will occur and often can modify the medications you are taking to reduce the chance of a bad interaction from occurring. For example, <a href="https://www.marleydrug.com/blog/statin-muscle-pain-is-more-common-then-you-think-will-switching-statins-help" rel="noopener noreferrer" target="_blank">statin-related side effects like muscle pain</a> (called myalgia), while relatively rare, typically increase with the statin dosage. Therefore, if you are taking 40 mg of atorvastatin and are experiencing muscle aches or pain, your doctor may first try to reduce your dose to 20 mg to see if that will help.</p><p>Now how does this relate to drug interactions? As discussed earlier, 70-80% of medications are metabolized by the CYP450 family of enzymes. In addition, some supplements and certain foods can also interact with these enzymes. A classic example of the effects of a drug interaction occurs when someone takes atorvastatin in combination with grapefruit juice. Grapefruit juice inhibits the CYP450 family of enzymes. When this enzyme is blocked, this can result in an increased amount of atorvastatin in your blood, which can greatly increase the risk of muscle pains and aches.</p><p>That’s why it’s so important for your healthcare provider to know about all the over-the-counter products, supplements, and prescription medications you are currently taking.</p><h4><strong>Newer Statins bypass this common enzyme pathway and have reduced potential for certain drug interactions</strong></h4><p>There is good news. There is a newer statin available now called pitavastatin. Pitavastatin (available under the brand name of<a href="https://www.marleydrug.com/zypitamag" rel="noopener noreferrer" target="_blank"> Zypitamag<sup>®</sup></a> at Marley Drug) bypasses this enzyme family and is instead mainly processed by a less busy enzyme family called UDP-glucuronosyltransferases, or UGTs. This pathway results in a reduced potential for certain interactions with other medications. It’s like comparing a crowded freeway with a dedicated express lane.</p><p>If you ever experience <a href="https://www.marleydrug.com/blog/should-i-stop-taking-my-statin-medication" rel="noopener noreferrer" target="_blank">side effects from your statin</a>, be sure to talk to your healthcare team right away. There are lots of statin options available. If you have had issues with your statin in the past that doesn’t mean you will have the same issue with every single statin.&nbsp;Not all patients are the same. Not all statins are the same.</p>

A vast majority of the U.S population suffers from high cholesterol. Unlike most other diseases, high cholesterol frequently presents with no symptoms and can be considered a silent killer. Today, over 70 million adult Americans have high cholesterol, yet only 1 in…

Statins are a common medication to treat high cholesterol. Drug interactions can lead to statin side effects, however, these are often avoidable. Learn more.

How Drug Interactions Can Cause Statin Side Effects

Do Drug Interactions cause Statin Side Effects?

<h4>Why Complying with your Prescribed Regimen is Important.</h4><p>Statins are a class of drugs that lower low-density lipoprotein (LDL) <a href="https://www.marleydrug.com/high-cholesterol" rel="noopener noreferrer" target="_blank">cholesterol</a>. They are at the forefront of protecting your health against cardiovascular diseases and decreasing mortality rates.</p><p>How statins work: Statins work by inhibiting the liver’s ability to produce LDL cholesterol while also aiding the organ in removing existing fats in the blood.</p><p>High <a href="https://www.marleydrug.com/blog/cholesterol-what-it-is-and-why-you-should-care" rel="noopener noreferrer" target="_blank">cholesterol is a silent killer</a> as it has no symptoms. That’s why it’s so important to have regular check-ups with your healthcare provider. With one-third of all Americans meeting the criteria for high levels of unhealthy cholesterol, they are one of, if not the most widely prescribed medication in the United States.</p><p><img src="https://marley-storage.imgix.net/034e24b0-5ef4-4d39-af37-bf9351819d88/bl-statins-cholesterol-2.jpg"><br><br><strong>What Studies Show:</strong> Countless clinical trials have repeatedly demonstrated the successful role of statins in the management of patients with diagnosed cardiovascular disease (secondary prevention), and those with a high risk for cardiovascular disease (primary prevention).</p><p><strong>Did you know:</strong> Studies have also presented the various risks of suddenly withdrawing from statin therapy.</p><p>Discontinuation of a statin should only happen with the guidance of a licensed medical professional; however, despite this precaution, it is estimated by the American College of Cardiology that 10% of statin users stop taking their medication altogether, most commonly because of <a href="https://www.marleydrug.com/blog/stopped-taking-your-statin-because-of-muscle-pain-we-may-have-a-new-solution-for-you" rel="noopener noreferrer" target="_blank">muscle symptoms</a>.<sup>1</sup> Other studies have reported discontinuation rates as high as 47%.<sup>2</sup></p><h3>Dangers of Stopping Your Statin.</h3><p>Stopping your prescribed regimen of statin significantly increase your risk for cardiovascular disease, greater incidences of hospitalization, and greater risk of death.</p><p>A study including 45,151 participants who had previously been hospitalized for an ischemic stroke found that people who quit taking statins three to six months after having a stroke were 42% more likely to have a second stroke within six to eighteen months.<sup>3</sup></p><p>Further, an analysis of 120,173 people found that those who stopped taking their statin medication faced a 33% increased chance of being admitted to the hospital for cardiovascular ailments.<sup>4</sup></p><p>The same clinical trial reports that older people who discontinued statin usage had a 46% higher risk of experiencing heart problems and a 26% higher risk of experiencing a vascular event, such as a stroke.<sup>4</sup></p><h3>Tips to Overcome Obstacles and Enhance Your Health.</h3><p>Talking to your healthcare provider is the first step. They can work with you to create an individually-tailored approach that addresses your needs, concerns and develops strategies you can use to improve your adherence.</p><p>Over half of the patients who had stopped compliance with their prescribed statin-related treatment were successfully restarted, many on the same drug and some who continued taking it over the course of a year.<sup>2</sup></p><p>Telling your physician of any possible side effects you may be getting from one statin is essential, as is notifying them about your wishes to terminate your treatment.</p><p>There are currently <a href="https://www.marleydrug.com/compare-statins" rel="noopener noreferrer" target="_blank">seven approved statin medications</a> available to patients and recommendations can be made towards <a href="https://www.marleydrug.com/blog/statin-muscle-pain-is-more-common-then-you-think-will-switching-statins-help" rel="noopener noreferrer" target="_blank">changing your regimen</a> or lowering your dosage rather than eradicating it.</p><p><br></p><h6>References<br>1 Newman C et al. Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association. Published in December 2018 in the Arteriosclerosis, Thrombosis and Vascular Biology Journal<br>2 Vinogradova Y et al. Discontinuation and restarting in patients on statin treatment: prospective open cohort study using a primary care database. Published June 2016 in the British Medical Journal.<br>3 Lee M et al. Utilization of Statins Beyond the Initial Period After Stroke and 1‐Year Risk of Recurrent Stroke. Published August 2017 in the Journal of the American Heart Association.<br>4 Giral P. et al. Cardiovascular effect of discontinuing statins for primary prevention at the age of 75 years: a nationwide population-based cohort study in France. Published November 2019 in the European Heart Journal</h6><p><br></p>

Stopping statin therapy significantly increases your risk for cardiovascular disease. Talk to your physician about alternatives.

Discontinuation of a statin should only happen with the guidance of a licensed medical professional. Learn more about the pros and cons of statin therapy.

Should I stop taking my statin medication?

Helpful Articles on Zypitamag

Add complementary LDL-C lowering. See Phase III data for pitavastatin + ezetimibe and how to send both prescriptions to Marley Drug.

Help Your Patients Get More LDL-C Lowering