Atorvastatin + Ezetimibe

Find more information about this combination medication at the webpages for Atorvastatin and Ezetimibe

Familial Combined Hyperlipidemia, Coronary Artery Disease ... show more

Advisory

  • This medicine contains a combination of 2 drugs Atorvastatin and Ezetimibe.
  • Atorvastatin and Ezetimibe are both used to treat the same disease or symptom but work in different ways in the body.
  • Most doctors will advise making sure that each individual medicine is safe and effective before using a combination form.

Drug Status

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Government Approvals

None

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WHO Essential Medicine

NO

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Known Teratogen

NO

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Pharmaceutical Class

Dietary Cholesterol Absorption Inhibitor and HMG-CoA Reductase Inhibitor

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Controlled Drug Substance

NO

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Summary

  • Atorvastatin and Ezetimibe are used to treat high cholesterol and related conditions like familial hypercholesterolemia, a genetic disorder that causes high cholesterol levels. They're also used to reduce the risk of heart attacks and strokes in people with heart disease or those at high risk.

  • Atorvastatin works by blocking an enzyme in the liver that's responsible for cholesterol production. Ezetimibe works by reducing cholesterol absorption in the intestine. Together, they lower cholesterol levels in the blood.

  • The usual adult daily dose for Atorvastatin ranges from 10 mg to 80 mg. Ezetimibe is typically prescribed at a dose of 10 mg per day. Both medications are taken orally, once daily.

  • Common side effects of Atorvastatin include diarrhea, heartburn, gas, joint pain, and muscle pain. Ezetimibe may cause diarrhea, sore throat, and joint pain. Both medications can lead to muscle-related side effects like myopathy (muscle disease) or rhabdomyolysis (breakdown of muscle tissue).

  • Atorvastatin and Ezetimibe should not be used during pregnancy or breastfeeding, or in individuals with active liver disease or unexplained persistent elevations in liver enzymes. They may cause muscle-related side effects, especially when used with certain other drugs. Patients should avoid excessive alcohol and grapefruit juice.

Indications and Purpose

What is combination of Atorvastatin and Ezetimibe used for?

Atorvastatin and Ezetimibe are indicated for the treatment of high cholesterol and related conditions, such as familial hypercholesterolemia, a genetic disorder that causes high cholesterol levels. They are also used to reduce the risk of cardiovascular events like heart attacks and strokes in individuals with heart disease or those at high risk. Atorvastatin is particularly effective in lowering LDL cholesterol and triglycerides, while Ezetimibe is used to enhance cholesterol reduction by inhibiting its absorption in the intestine. Together, they provide a comprehensive approach to managing cholesterol levels and reducing cardiovascular risk.

How does combination of Atorvastatin and Ezetimibe work?

Atorvastatin works by inhibiting the enzyme HMG-CoA reductase in the liver, which is crucial for cholesterol production, thereby reducing the amount of cholesterol produced by the body. Ezetimibe acts by blocking the absorption of cholesterol in the small intestine, reducing the amount of cholesterol that enters the bloodstream. Together, they provide a comprehensive approach to lowering cholesterol levels by targeting both production and absorption. This dual mechanism helps achieve greater reductions in LDL cholesterol and overall cholesterol levels, improving cardiovascular health.

How effective is combination of Atorvastatin and Ezetimibe?

Clinical studies have demonstrated that Atorvastatin effectively lowers LDL cholesterol and triglycerides, reducing the risk of cardiovascular events. Ezetimibe has been shown to further enhance cholesterol reduction by inhibiting its absorption in the intestine. When used together, these medications provide a more significant reduction in cholesterol levels than either drug alone. The combination has been proven to lower the incidence of heart attacks and strokes in high-risk patients. Both drugs are well-studied and have a strong evidence base supporting their use in managing high cholesterol and reducing cardiovascular risk.

How does one know if combination of Atorvastatin and Ezetimibe is working?

The benefit of Atorvastatin and Ezetimibe is primarily assessed through regular blood tests that measure cholesterol levels, including total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. The goal is to achieve and maintain target cholesterol levels, which are determined based on individual risk factors for heart disease. Both medications aim to lower LDL cholesterol significantly, and their effectiveness is evaluated by the reduction in these levels. Additionally, the combination may be assessed by its ability to reduce the need for cardiovascular interventions and decrease the incidence of heart attacks and strokes.

Directions for Use

What is the usual dose of combination of Atorvastatin and Ezetimibe?

The usual adult daily dose for Atorvastatin ranges from 10 mg to 80 mg, depending on the individual's cholesterol levels and response to treatment. Ezetimibe is typically prescribed at a dose of 10 mg per day. When used in combination, the dosing of Atorvastatin may be adjusted based on the desired cholesterol-lowering effect and the patient's tolerance. Both medications are taken once daily, and the combination allows for a more comprehensive approach to lowering cholesterol by targeting both cholesterol production in the liver and absorption in the intestine.

How does one take combination of Atorvastatin and Ezetimibe?

Atorvastatin can be taken with or without food, but it should be taken at the same time each day to maintain consistent blood levels. Ezetimibe can also be taken with or without food. Patients are advised to follow a low-fat, low-cholesterol diet while on these medications. It's important to avoid consuming large amounts of grapefruit juice, as it can interact with Atorvastatin and increase the risk of side effects. Both medications should be taken as prescribed, and any changes in dosing should be discussed with a healthcare provider.

For how long is combination of Atorvastatin and Ezetimibe taken?

Atorvastatin and Ezetimibe are typically used as long-term treatments to manage cholesterol levels and reduce cardiovascular risk. The duration of use is often indefinite, as these medications are part of a comprehensive approach to maintaining heart health, which includes diet and lifestyle changes. Regular monitoring of cholesterol levels helps determine the ongoing need for these medications. Both drugs are intended for continuous use to maintain their cholesterol-lowering effects and prevent heart-related complications.

How long does it take for combination of Atorvastatin and Ezetimibe to work?

Atorvastatin and Ezetimibe work together to lower cholesterol levels, but they have different mechanisms and onset times. Atorvastatin, a statin, begins to lower cholesterol within 2 weeks, with maximum effects usually seen within 4 weeks. Ezetimibe, which inhibits cholesterol absorption in the intestine, also starts working within a few weeks. When combined, these medicines can provide a more significant reduction in cholesterol levels, but the full effect may take a few weeks to be noticeable. Both medicines are used to manage cholesterol levels over the long term, and their benefits are typically assessed through regular blood tests to monitor cholesterol levels.

How does one store combination of Atorvastatin and Ezetimibe?

Atorvastatin and Ezetimibe do not require refrigeration. They should be stored at room temperature, between 20°C to 25°C (68°F to 77°F), and protected from moisture and light. It's important to keep these medications in their original containers, tightly closed, and out of reach of children. Proper storage ensures the effectiveness and safety of the medications. Both drugs share these storage requirements, making it convenient for patients to manage their medication regimen.

Warnings and Precautions

Are there harms and risks from taking combination of Atorvastatin and Ezetimibe?

Common side effects of Atorvastatin include diarrhea, heartburn, gas, joint pain, and muscle pain. Ezetimibe may cause diarrhea, sore throat, and joint pain. Both medications can lead to muscle-related side effects, such as myopathy or rhabdomyolysis, which are serious conditions involving muscle pain and weakness. Liver enzyme abnormalities are also a concern with both drugs, requiring regular monitoring. While both medications are generally well-tolerated, patients should report any unusual symptoms to their healthcare provider to manage potential adverse effects effectively.

Can I take combination of Atorvastatin and Ezetimibe with other prescription drugs?

Atorvastatin interacts with drugs like cyclosporine, certain antibiotics (e.g., clarithromycin), and antifungals (e.g., itraconazole), which can increase the risk of muscle problems. Ezetimibe can interact with bile acid sequestrants, which may reduce its effectiveness. Both drugs can interact with other cholesterol-lowering medications, increasing the risk of side effects. It's crucial to inform healthcare providers about all medications being taken to manage potential interactions and adjust dosages as necessary. Regular monitoring helps ensure safe and effective use of these medications.

Can I take combination of Atorvastatin and Ezetimibe with vitamins or supplements?

Atorvastatin and Ezetimibe can interact with certain vitamins and supplements. For instance, niacin, a vitamin B3 supplement, can increase the risk of muscle problems when taken with Atorvastatin. Patients should also be cautious with supplements that affect liver function, as both medications can impact liver enzymes. It's important to inform healthcare providers about all supplements being taken to avoid potential interactions. Regular monitoring and consultation with a healthcare provider can help manage these interactions effectively.

Can I take combination of Atorvastatin and Ezetimibe if I am pregnant?

Atorvastatin and Ezetimibe are contraindicated during pregnancy due to the potential risk of harm to the developing fetus. Cholesterol is essential for fetal development, and reducing cholesterol levels during pregnancy can interfere with normal fetal growth. Women of childbearing age should use effective contraception while taking these medications and discontinue use if they become pregnant. Healthcare providers should be consulted to discuss alternative treatments for managing cholesterol during pregnancy.

Can I take combination of Atorvastatin and Ezetimibe while breastfeeding?

Atorvastatin and Ezetimibe are not recommended during breastfeeding. Atorvastatin may pass into breast milk and could potentially harm a nursing infant. The effects of Ezetimibe on breast milk are not well-studied, but due to the potential for adverse effects, it is advised to avoid using these medications while breastfeeding. Women who require cholesterol-lowering treatment during lactation should discuss alternative options with their healthcare provider to ensure the safety of the infant.

Who should avoid taking combination of Atorvastatin and Ezetimibe?

Atorvastatin and Ezetimibe are contraindicated in individuals with active liver disease or unexplained persistent elevations in liver enzymes. They should not be used during pregnancy or breastfeeding due to potential harm to the fetus or infant. Both medications carry a risk of muscle-related side effects, such as myopathy and rhabdomyolysis, especially when used with certain other drugs. Patients should avoid excessive alcohol consumption and grapefruit juice, which can increase the risk of side effects. Regular monitoring of liver function and muscle enzymes is recommended to ensure safe use.