atorvastatin and ezetimibe

Generic name: atorvastatin and ezetimibe [ a-TOR-va-STAT-in-and-e-ZET-i-mibe ]
Brand name: Liptruzet
Drug class: Antihyperlipidemic combinations

What is atorvastatin and ezetimibe?

Ezetimibe reduces the amount of cholesterol absorbed by the body.

Atorvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins."

Atorvastatin and ezetimibe is a combination medicine that reduces blood levels of "bad" cholesterol, such as low-density lipoprotein (LDL), apolipoprotein-B (apo-B), triglycerides, or non-high-density lipoprotein (non-HDL).

Atorvastatin and ezetimibe is used together with a low-fat diet and other treatments to lower total cholesterol in adults with familial hypercholesterolemia (an inherited type of high cholesterol).

It is not known whether atorvastatin and ezetimibe reduces your risk of heart disease.

Atorvastatin and ezetimibe may also be used for purposes not listed in this medication guide.

What is the most important information I should know about atorvastatin and ezetimibe?

You should not use this medicine if you have active liver disease or abnormal liver function tests.

Do not use atorvastatin and ezetimibe if you are pregnant or if you could become pregnant. Use effective birth control.

Do not breast-feed while using this medicine.

What should I discuss with my healthcare provider before taking atorvastatin and ezetimibe?

You should not use this medicine if you are allergic to atorvastatin (Lipitor) or ezetimibe (Vytorin, Zetia), or if you have:

• active liver disease;

• abnormal liver function tests; or

• if you are pregnant or breast-feeding.

To make sure this medicine is safe for you, tell your doctor if you have:

• a thyroid disorder;

• a history of liver or kidney disease;

• a history of liver problems caused by alcohol;

• gallbladder disease or a history of gallstones;

• low blood pressure;

• a history of blood clot or stroke, including "mini-stroke" (TIA);

• diabetes;

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

• untreated or uncontrolled seizures;

• if you drink large amounts of alcohol; or

• if you are older than 65.

FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not use atorvastatin and ezetimibe if you are pregnant. Use effective birth control. Stop using the medicine and tell your doctor right away if you become pregnant.

It is not known whether atorvastatin and ezetimibe passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Related/similar drugs

Leqvio, atorvastatin, rosuvastatin, simvastatin, ezetimibe, Crestor, Zetia

How should I take atorvastatin and ezetimibe?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not crush, chew, or dissolve an atorvastatin and ezetimibe tablet. Swallow it whole.

While using this medicine, you may need frequent blood tests.

If you have major surgery or a severe injury or infection, make sure any doctor caring for you knows you are taking atorvastatin and ezetimibe.

Store at room temperature away from moisture and heat. Keep the medicine in the foil pouch or plastic case when not in use.

After opening a foil pouch, store it in a dry place protected from light. Discard any tablets not used within 30 days after opening the pouch.

Each time you take a tablet out of a blister card, place the card back into the plastic case.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking atorvastatin and ezetimibe?

Grapefruit and grapefruit juice may interact with this medicine and lead to unwanted side effects. Avoid the use of grapefruit products while taking atorvastatin and ezetimibe.

Avoid eating foods that are high in fat or cholesterol. Atorvastatin and ezetimibe will not be as effective in lowering your cholesterol if you do not follow a cholesterol lowering diet plan.

If you also take cholestyramine, colesevelam, or colestipol: Space your doses apart in order to take atorvastatin and ezetimibe either 2 hours before or 4 hours after you take any of these other medications.

Atorvastatin and ezetimibe side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

In rare cases, atorvastatin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

Stop using this medicine and call your doctor at once if you have:

• nausea, upper stomach pain, loss of appetite;

• itching, unusual tiredness; or

• dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

• mild muscle pain;

• stomach pain, diarrhea; or

• joint pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Atorvastatin and ezetimibe dosing information

Usual Adult Dose for Hyperlipidemia:

Initial dose: Atorvastatin-ezetimibe 10/10 or 20/10 mg orally once daily
Initial dose for patients who require a larger reduction in LDL-C (greater than 55%): Atorvastatin-ezetimibe 40/10 mg orally once daily
Titration: After initiation and/or upon titration of atorvastatin-ezetimibe, lipid levels should be analyzed within 2 or more weeks and dosage adjusted accordingly.

Patients with Homozygous Familial Hypercholesterolemia:
Dosage: Atorvastatin-ezetimibe 40/10 or 80/10
Comments: Atorvastatin-ezetimibe should be used as an adjunct to other lipid-lowering treatments (e.g., LDL apheresis) in these patients or if such treatments are unavailable.

Approved indications:
Indicated as adjunctive therapy to diet to:
-Reduce elevated total-C, LDL-C, Apo B, TG, and non-HDL-C, and to increase HDL-C in patients with primary (heterozygous familial and nonfamilial) hyperlipidemia or mixed hyperlipidemia.
-Reduce elevated total-C and LDL-C in patients with homozygous familial hypercholesterolemia (HoFH), as an adjunct to other lipid-lowering treatments.

What other drugs will affect atorvastatin and ezetimibe?

Many drugs can interact with this medicine. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with atorvastatin and ezetimibe, especially:

• colchicine;

• cyclosporine;

• digoxin, digitalis;

• imatinib;

• isoniazid;

• nefazodone;

• niacin, vitamin B3;

• St. John's wort;

• an antibiotic--clarithromycin, erythromycin, rifampin, telithromycin;

• antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole;

• birth control pills;

• a blood thinner (warfarin, Coumadin);

• heart medication--nicardipine, quinidine;

• hepatitis C medications--boceprevir, telaprevir;

• HIV/AIDS medication--atazanavir, darunavir, delavirdine, efavirenz, fosamprenavir, indinavir, lopinavir, nelfinavir, nevirapine, ritonavir, saquinavir, tipranavir;

• other cholesterol medications, especially fenofibrate, fenofibric acid, gemfibrozil, or any other "statin" medicine.

• seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; or

• tuberculosis medication--rifabutin, rifampin, rifapentine.

This list is not complete and many other drugs can interact with atorvastatin and ezetimibe. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Last reviewed: July 18, 2013
Date modified: May 03, 2017

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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