Ezetimibe (Zetia) is a drug used to lower LDL cholesterol values in the blood.
How it works
Ezetimibe belongs to a new class of lipid-lowering substances active in the intestine, where they selectively reduce the absorption of cholesterol and associated phytosterols, without however interfering with that of fat-soluble vitamins.
Ezetimibe is also effective when taken in combination with meals low in cholesterol, as it also inhibits the absorption of the amount excreted through the bile.
In this sense, ezetimibe proves to be a valid alternative to bile acid sequestering resins, thanks to its ability to leave plasma triglyceride levels unaltered (unlike resins, which tend to increase them).
How to use
Ezetimibe is usually given at doses of 10 mg / day.
Effectiveness
In patients affected by primary hypercholesterolemia, it allowed an average reduction in plasma LDL values of approximately 15-20%, accompanied by a slight increase in HDL (4-9%).
Who is it for?
Ezetimibe is recommended for patients who require a modest reduction in their LDL cholesterol level. It is also used in combination with statins when they need to be taken in moderation or when you want to maximize the reduction in LDL cholesterol levels through an additive effect; in this sense, the most commonly used association is that with simvastatin, often enclosed within the same tablet.
Ezetimibe can also be associated with fenofibrate in the treatment of mixed hyperlipidemia, which is characterized - that is - by high cholesterol and triglyceride values.
Given its ability to significantly reduce intestinal absorption of phytosterols, ezetimibe is indicated in the monotherapy of familial homozygous sitosterolemia or phytosterolemia (a rare genetic disease).
Given the recent introduction of ezetimibe in the treatment of hypercholesterolemia, a prudent approach may be to use the drug only when statins are not tolerated by the patient or when they fail to produce satisfactory cholesterol reductions.
Side effects
Side effects, generally absent, are mostly limited to the onset of headache and diarrhea (resulting from steatorrhea). Even more rare are muscle problems (muscle soreness similar to that caused by fibrates and statins) and increased transaminase levels.
More information on ezetimibe is available in the package insert of the drug Zetia ®.
