Drug Interactions between flax and Roszet
This report displays the potential drug interactions for the following 2 drugs:
- flax
- Roszet (ezetimibe/rosuvastatin)
Interactions between your drugs
flax ezetimibe
Applies to: flax and Roszet (ezetimibe / rosuvastatin)
MONITOR: Concomitant use of flaxseed oil with ezetimibe may lead to lower plasma alpha-linolenic acid (ALA) levels. The mechanism may be related to ezetimibe-mediated inhibition of intestinal absorption of ALA contained in flaxseed oil. However, data for this interaction are conflicting. In one study, 34 cardiac disease patients were randomized into 4 groups for a 6-week trial of a daily dose of either: placebo, 10 mg ezetimibe, 2 g flaxseed oil (equivalent to 1 g ALA), or 10 mg ezetimibe with 2 g flaxseed oil. The flaxseed oil group presented a significant increase in ALA plasma levels of 6 mcg/dL, and the other groups showed a decrease in ALA plasma levels of 2 to 4 mcg/dL as compared to baseline. However, according to ezetimibe product labeling, preclinical studies showed no effects of ezetimibe on fatty acid absorption.
MANAGEMENT: Until further information is available, clinical or laboratory monitoring of the expected therapeutic benefits of flaxseed oil is recommended when ezetimibe is co-administered with flaxseed oil.
References
- (2002) "Product Information. Zetia (ezetimibe)." Schering-Plough Corporation
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
ezetimibe rosuvastatin
Applies to: Roszet (ezetimibe / rosuvastatin) and Roszet (ezetimibe / rosuvastatin)
MONITOR: Coadministration with ezetimibe may rarely increase the risk of myopathy and serum transaminase elevations associated with HMG-CoA reductase inhibitors (i.e., statins). The mechanism of interaction is unknown. A case report describes two patients whose serum creatine kinase increased after ezetimibe was added to their statin therapy (atorvastatin and fluvastatin, respectively). One of the patients also developed myalgia and tendinopathy, which resolved promptly after withdrawal of both drugs. Statin therapy was subsequently reintroduced at the previous dosage without incident. In the other patient, serum creatine kinase returned to normal within 4 weeks after discontinuation of ezetimibe while the statin was continued. On the contrary, no cases of myopathy or tendinopathy occurred in a study of 33 hypercholesterolemic patients treated with ezetimibe and atorvastatin or simvastatin. There were also no reports of myopathy or significant increases in serum creatine kinase in a study of 32 subjects treated with ezetimibe and fluvastatin. In controlled clinical studies, the incidence of consecutive elevations (greater than 3 times the upper limit of normal) in serum transaminases was 1.3% for patients treated with ezetimibe in combination with a statin versus 0.4% for patients treated with a statin alone. These elevations were generally asymptomatic, not associated with cholestasis, and returned to baseline after discontinuation of therapy or with continued treatment.
MANAGEMENT: Until further information is available, use of a statin in combination with ezetimibe should be approached with caution. Patients should be advised to promptly report to their physician any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. The drugs should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed. In addition, liver function tests should be performed at initiation of therapy and according to the recommendations of the HMG-CoA reductase inhibitor.
References
- Gagne C, Gaudet D, Bruckert E (2002) "Efficacy and safety of ezetimibe coadministered with atorvastatin or simvastatin in patients with homozygous familial hypercholesterolemia." Circulation, 105, p. 2469-75
- Fux R, Morike K, Gundel UF, Hartmann R, Gleiter CH (2004) "Ezetimibe and statin-associated myopathy." Ann Intern Med, 140, p. 671-2
Drug and food interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Check Interactions
To view an interaction report containing 4 (or more) medications, please sign in or create an account.
Save Interactions List
Sign in to your account to save this drug interaction list.