Atorvastatin and Ezetimibe (Oral)

Atorvastatin and ezetimibe in combination are used to treat high levels of cholesterol and triglyceride in the blood.

Overview

Atorvastatin and ezetimibe are used in combination with a healthy diet, to treat high levels of cholesterol and triglyceride (fat) in the blood. This medication can be effective in preventing health problems associated with high cholesterol, including stroke and heart attack, which can be caused by obstructed blood vessels.

Atorvastatin and ezetimibe is also used to treat a condition called homozygous familial hypercholesterolemia (HoFH). Homozygous familial hypercholesterolemia is a severe condition that is caused by a faulty or altered gene from both parents. The condition causes sufferers to have blood cholesterol levels that are extremely high. The unnaturally high cholesterol accumulates in the patient's arteries, blocking them, and ultimately leading to serious heart disease much more quickly than would be seen in the general population.

Atorvastatin is an HMG-CoA reductase inhibitor (statin), and ezetimibe is a cholesterol absorption inhibitor. This medication works by reducing the body's absorption of cholesterol and fats from the food that you eat, as well as inhibiting the production of cholesterol by your body.

This medication is only available on prescription from your doctor and comes in tablet form. In the US, atorvastatin and ezetimibe is sold under the brand name, Liptruzet.

Conditions treated

Type of medicine

  • HMG-CoA reductase inhibitor
  • cholesterol absorption inhibitor
  • tablet

Side-effects

Along with the many benefits that atorvastatin and ezetimibe can provide, some patients sometimes suffer some unwanted side effects. You may not experience any side effects when you are taking this medication, but if you do notice any unusual or unpleasant effects, you should consult your doctor, as you may need further medical attention.

The side effects shown below sometimes occur in people taking atorvastatin and ezetimibe and should be reported to your treating physician without delay:

  • weakness or heaviness of the legs
  • unusual tiredness or weakness
  • unusual bleeding or bruising
  • unsteadiness or awkwardness
  • sores, ulcers, or white spots in the mouth or on the lips
  • severe nausea or vomiting
  • numbness or tingling in the hands, feet, or lips
  • muscle, joint, or bone pain
  • muscle weakness or stiffness
  • light-colored stools
  • large swellings affecting the face, eyelids, lips, throat, tongue, feet, hands, legs, or genitals
  • jaundice
  • itching
  • irregular heartbeat
  • hives, welts, or skin rash
  • fever
  • difficult breathing
  • diarrhea
  • dark-colored urine
  • confusion
  • chills
  • blood in the urine or stools
  • blistering, peeling, or loosening of the skin
  • black, tarry stools

There are a few side effects that sometimes occur in patients who are taking atorvastatin and ezetimibe that do not usually need further treatment. These effects often resolve themselves over time as your body becomes acclimatized to the drug. Your doctor may give you some advice on how to manage or reduce many of these unpleasant side effects if they are persistent or particularly bothersome.

  • trouble sleeping
  • trouble concentrating
  • tiredness
  • tightness in the chest
  • sudden sweating
  • a stuffy or runny nose
  • redness of the face, neck, arms, and occasionally, upper chest
  • pains in the side, back, or abdomen
  • pain or tenderness around the eyes and cheekbones
  • loss of memory
  • lack of appetite
  • irritability
  • feeling too hot
  • feeling sad or empty
  • fast heartbeat
  • dizziness
  • cough
  • constipation
  • bloating burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • being forgetful

This list of side effects is not exhaustive. If you experience any other unusual effects, you should consult your doctor without delay.

Dosage

You will be issued a medication guide when you are prescribed this medication by your doctor. Read the guide thoroughly and make sure that you understand how to take the medicine. If you have any questions, just ask your doctor.

You must only take this medication exactly as directed by your treating physician. Do not take more than the dose you have been prescribed. Do not take the medication more frequently that you have been directed to. Do not continue taking the medication for longer than directed by your doctor. Do not miss out any doses; to do so could increase the likelihood of you suffering side effects and will reduce the efficacy of the medication. You should be aware that it could take a couple of weeks for the medication to take effect.

The dose of atorvastatin and ezetimibe that patients are prescribed will vary. You must follow your doctor's instructions or the directions given on the medication prescription label. The dose that is given below is based on the average dosage. If the dose you are prescribed is different, do not alter it, unless you are instructed otherwise by your doctor. The dose of this medication that you are given will depend on the strength of the tablets, as will how many you need to take each day. The length of your course of treatment may also change, depending on what you are being treated for.

For the treatment of high cholesterol and triglycerides

  • Adults: initially, one tablet per day, once daily. This may be increased as required, however the dose is not usually more than 10 mg of ezetimibe and 80 mg of atorvastatin.
  • Children: use and dose to be determined by your doctor.

For the treatment of homozygous familial hypercholesterolemia (HoFH)

  • Adults: initially, one tablet per day, once daily. The dose may be 10 mg of ezetimibe and 40 mg of atorvastatin, 10 mg of ezetimibe and 80 mg of atorvastatin.
  • Children: use and dose to be determined by your doctor.

Swallow the tablets whole. Do not chew, break, or crush up the tablets. You may take the tablets before or after eating. If possible, try to take your medication at the same time every day.

If you miss a dose of your medication, try to take the missed dose as soon as possible. If your next dose is almost due, omit the one you have omitted and resume your usual dosage schedule. Do NOT take double the dose to try to catch up.

Do not share your atorvastatin and ezetimibe tablets with anyone else.

If you begin to feel worse after you start taking this medication, or if you do not think that your condition has actually improved, consult your doctor or specialist promptly.

In the event that you accidentally take an overdose of this medication, you may experience breathing difficulties or have fainting episodes. If you do think that you might have overdosed, call 911 immediately, or seek your treating physician's advice.

Major drug interactions

Some types of drugs should never be used together, as this may affect how your medicines work and it could increase the risk of serious side effects. However, in some cases, it is possible to use two or more different medications at the same time, even though an interaction between them does occur. In this case, your doctor may change the dose of one of your medicines. Alternatively, your doctor may suggest some ways in which you can negate the effect of any interactions.

Before taking this medication, make a list of all medications that you currently use. This list should include prescription and non-prescription drugs, herbal preparations, and vitamin products. Show this list to your doctor before commencing your treatment with atorvastatin and ezetimibe. Do not change the dose or frequency of any of your prescribed or other over-the-counter medications without first consulting your doctor.

Although using atorvastatin and ezetimibe with the following medications is not recommended, it may be necessary for some patients. Your doctor will advise you if you need to change the dose or frequency of use of any of your medicines.

  • Voriconazole
  • Verapamil
  • Troleandomycin
  • Tipranavir
  • Telithromycin
  • Telaprevir
  • St John's Wort
  • Simeprevir
  • Saquinavir
  • Rifampin
  • Quinupristin
  • Quinine
  • Piperaquine
  • Pioglitazone
  • Phenytoin
  • Pectin
  • Oat Bran
  • Niacin
  • Nelfinavir
  • Nefazodone
  • Mibefradil
  • Lopinavir
  • Ketoconazole
  • Itraconazole
  • Isavuconazonium Sulfate
  • Interferon Beta
  • Indinavir
  • Idelalisib
  • Grazoprevir
  • Gemfibrozil
  • Fusidic Acid
  • Fosphenytoin
  • Fosamprenavir
  • Fluconazole
  • Fenofibric Acid
  • Fenofibric Acid
  • Fenofibrate
  • Fenofibrate
  • Etravirine
  • Erythromycin
  • Eltrombopag
  • Eliglustat
  • Elbasvir
  • Efavirenz
  • Domperidone
  • Diltiazem
  • Digoxin
  • Darunavir
  • Daptomycin
  • Danazol
  • Dalfopristin
  • Cyclosporine
  • Cyclosporine
  • Conivaptan
  • Colestipol
  • Colchicine
  • Clopidogrel
  • Clofibrate
  • Clarithromycin
  • Ciprofibrate
  • Cholestyramine
  • Ceritinib
  • Bosentan
  • Boceprevir
  • Black Cohosh
  • Bezafibrate
  • Bexarotene
  • Azithromycin
  • Atazanavir
  • Amprenavir
  • Amiodarone

It should be noted that this list is not necessarily exhaustive. Always make sure your physician is aware if you are already taking any other form of medication before you start your course of atorvastatin and ezetimibe.

Warnings

While you are taking this medication, you will need to see your doctor for regular progress checks. These check-ups are important as they allow your doctor to make sure that the medication is working correctly. You will also have the opportunity to discuss any side effects that you may be suffering and to ask any questions that you may have about your new medicine. During your check-ups, your doctor may wish to carry out blood tests to check for any unwanted effects that the drug is causing.

You must tell your doctor if you are known to be allergic to food colorings, certain foodstuffs, preservatives, or animal derivatives.

While you are taking this medication, your doctor may suggest that you change your diet to one that is low in sugar, cholesterol, and fat.

If you are already taking medications that are known to lower cholesterol, you should take Liptruzet two hours beforehand or four hours afterwards.

You should not drink more than half a pint of grapefruit juice per day.

Avoid drinking alcohol with this medication, as it could cause liver problems.

Be sure to tell your doctor if you have any other existing medical conditions, especially:

  • alcoholism
  • diabetes
  • hyperthyroidism
  • kidney disease
  • liver disease or elevated liver enzymes
  • history of heart disease
  • have ever suffered a stroke
  • transient ischemic attack within the last six months
  • hypotension
  • infection
  • major surgery
  • metabolic, endocrine, and electrolyte disorders
  • seizures
  • trauma

If you think you might be pregnant, you should tell your doctor immediately. Taking atorvastatin and ezetimibe if you are pregnant can seriously harm the unborn baby. Take steps to avoid conception for the duration of your treatment with this medication. This medication passes into breast milk. Do not breastfeed when using this drug and do not express milk to feed your baby. Ask your doctor or midwife for more advice on alternatives for feeding your baby.

If you experience unexplained muscle pain, tenderness or weakness, fever or feelings of unexplained tiredness, you should tell your doctor immediately - these could be symptomatic of serious muscle problems, including necrotizing myopathy (IMNM) or immune-mediated myopathy.

Sometimes this medication can cause kidney problems. If you experience fever, muscle spasms or cramps, pain or stiffness, unusual weakness or tiredness, and notice that your urine is very dark in color, contact your doctor immediately.

This medication can cause liver problems in some patients. If you begin to notice pain or tenderness in the upper part of your stomach, pale stools, very dark urine, vomiting or nausea, or jaundice, contact your doctor immediately.

In the event that you are due to undergo major surgery or dental treatment, or if you suffer a major injury, be sure to tell your physician that you are taking this medication.

Storage

You should always keep your supply of atorvastatin and ezetimibe in a sealed, airtight container. This medicine must be kept at room temperature. Do not freeze the medication. Keep the medication dry and do not place it in direct sunlight or where it could be affected by sources of extreme heat, such as radiators or fires.

You must keep your medicine in the blister pack it is supplied in, until you are ready to take your daily dose. Once the blister pack has been opened, keep it somewhere dry and away from light and moisture. Once you have taken a table out of the pack, slide the blister card back into its protective folded card.

Always keep your medication where it cannot be accessed by children or pets. If a pet does consume atorvastatin and ezetimibe, you should seek immediate veterinary advice.

Do not keep any unwanted atorvastatin and ezetimibe tablets. Do not use any medicines that have exceeded their use-by date. Do not flush any of your unwanted medication down the toilet or place it into the drains. Do not throw out unused medication with your garbage; atorvastatin and ezetimibe tablets may be mistaken for candy and consumed by a child.

If in doubt, always seek the advice of your doctor or pharmacist if you need to dispose of any unused or unwanted medicines.

Summary

In the US, atorvastatin and ezetimibe is available under the brand name Liptruzet.

Atorvastatin and ezetimibe are very effective when used in conjunction with the correct diet, to treat people with high cholesterol and triglyceride (fat) levels in their blood. Lower cholesterol and fat can help to prevent potentially life-threatening health problems, such as stroke and heart attack. This medication can also be used in the treatment of a condition called homozygous familial hypercholesterolemia (HoFH).

Atorvastatin is an HMG-CoA reductase inhibitor (statin) and works by inhibiting the production of cholesterol by the body. Ezetimibe is a cholesterol absorption inhibitor and prevents the body from soaking up harmful cholesterol from the food you eat.

There are a number of prescription-only and over-the-counter drugs that can interact adversely with this medication. In addition, you should not drink grapefruit juice when taking atorvastatin and ezetimibe. Grapefruit can affect the body's ability to remove the medication from your body, potentially leading to a dose that is too high, or even causing an overdose.

Atorvastatin and ezetimibe are extremely effective in managing and controlling high cholesterol and triglyceride in the blood. In order to get the best from this medication, it is very important that you work closely with your doctor or specialist in order to work out the best dose and dosage schedule for the medication. You will also need to go to your doctor for regular check-ups and blood tests to make sure that the drug is working correctly and to ensure that there are no unwanted or harmful side effects.

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Last Reviewed:
December 25, 2017
Last Updated:
April 05, 2018
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