Ezetrol

Generic Name: Ezetimibe
Product Name: Ezetrol

• Indication of Ezetrol
• Action of Ezetrol
• Dose advice of Ezetrol
• Schedule of Ezetrol
• Common side effects of Ezetrol
• Uncommon side effects of Ezetrol

Indication of Ezetrol:

Ezetrol is used to reduce cholesterol levels in patients where it is too high (hypercholesterolaemia - high blood cholesterol levels). Cholesterol is a type of fatty substance found in the blood both absorbed form food and synthesized in the liver. There are good (HDL) and bad (LDL) types of cholesterol based on whether they lead to a build up of plaques in the blood vessels which can cause heart attacks and strokes. Ezetrol is often used in combination with other drugs known as statins (HMG-CoA reductase inhibitors) as well as lifestyle changes. Occasionally it may be used in patients who cannot tolerate these other medications. Some people are born with a genetic predisposition to high cholesterol, known as familial hypercholesterolaemia, which can be helped with drugs to lower cholesterol as well as reducing fat and cholesterol levels in the diet. Other patients have high levels of plant sterols in their blood (which doctors call sitosterolaemia) which will also be helped with Ezetrol. Ezetrol can be used in most cases where patients have elevated levels of cholesterol in the blood from numerous causes. In addition, patients with heart disease or diabetes (elevated blood sugars) are also treated with both statins and Ezetrol to reduce their cholesterol levels and reduce their risks of heart attack and stroke. See our information on Dual inhibition in lipid-lowering therapy.

^ top

Action of Ezetrol:

Ezetrol contains the active ingredient, ezetimibe which has a different mechanism to the other cholesterol lowering agents currently available. It works on the lining of the small intestine to reduce the absorption of cholesterol from food and recycled cholesterol in bile (a yellowish, thick fluid which helps to absorb fats). This reduces the stores of cholesterol in the liver and causes an increase in the removal of bad cholesterol from the bloodstream.This differs to other drugs such as statins which decrease production of cholesterol by the liver and bile acid binding resins which promote bile excretion. Due to the different mechanism of action, Ezetrol adds to the cholesterol lowering effects of these drugs when it is used in combination.

^ top

Dose advice of Ezetrol:

• You should take Ezetrol as prescribed by your doctor. The usual dose is 10 mg daily which comes as a single white/off-white tablet that is swallowed with water. Ezetrol can be taken at any tine of the day with or without food.
• This dose is suitable for most adults and children older than 10 years of age. Ezetrol is not recommended in children less than ten years as they are unsure of its effects. Furthermore, if you have active liver disease you should not take this medication.
• Often this medication will be used in combination with a statin so it may help you remember to take Ezetrol if you take them together at the same time everyday. However, if you are taking a bile acid sequestrant (e.g. cholestyramine) you must take Ezetrol at least 2 hours before or four hours after.
• If you are also taking statin medications, liver function tests are needed throughout your treatment to monitor that there is no damage to the liver.
• Remember a healthy diet with little fat and exercise are also important.
• Ezetrol is currently not recommended during pregnancy (if combined with a statin) or breastfeeding as there is no human data available regarding its safety.

^ top

Schedule of Ezetrol:

S4 (prescription required)

^ top

Common side effects of Ezetrol:

Like all medications, Ezetrol has the potential to cause side effects. Most of the time these will be mild and only temporary but you are encouraged to see your doctor if you are having any symptoms which are worrying you. The following are the most commonly reported side effects:

• Headache
• Diarrhoea
• General muscle aches

In addition, the drug can infrequently damage the liver and increase the levels of enzymes made by liver cells.

^ top

Uncommon side effects of Ezetrol:

Rarely this drug can have more serious side effects which require medical attention. These include:

• Allergic reactions: You should not take this medication if you are allergic to Ezetimibe or any of the active components of the drug. If an allergy does occur you may experience skin rash, swelling of the face, lips, mouth, throat or tongue and difficulty in swallowing or breathing (angioedema). Any sign of these symptoms should alert you to stop the medication and see a doctor immediately.
• Muscle disorders (myopathy or rhabdomyolysis): Ezetrol can quite severely damage the muscles, especially whan combined with a statin. You should tell your doctor if you develop muscle aches, pains and/or weakness. Muscle breakdown can be severe and cause kidney damage.
• Hepatitis: inflammation of the liver.
• Pancreatitis: Inflammation of the pancreas.

However, most patients tolerate the drug without any problems. You may experience side effects outside those listed above so talk to your doctor if you have any other concerns.

^ top

Reference:

1. Australian Medicines Handbook- Chapter 6.6.4 Ezetimibe, AMH Pty Ltd. 2006.
2. Australian Prescriber- RADAR - Ezetimibe (Ezetrol) for dyslipidaemia, 2005.
3. Consumer Medicine Information- Ezetrol, APPCo 2006.
4. MIMS Online- Prescribing Information, Ezetrol, MIMS Australia Pty Ltd 2003.

^ top

Treatments associated with Ezetrol:

• Dual Inhibition
  (Dual Inhibition in Lipid-lowering Therapy)

For further information talk to your doctor.

Article Dates:

Modified: 1/6/2006

Created: 31/5/2006