Zetia

— THERAPEUTIC CATEGORIES —
  • Hyperlipoproteinemias

Zetia Generic Name & Formulations

General Description

Ezetimibe 10mg; tabs.

Pharmacological Class

Cholesterol absorption inhibitor.

How Supplied

Tabs—30

Storage

Store at room temperature between 68ºF to 77ºF (20ºC to 25ºC). Protect from moisture.

Manufacturer

Generic Availability

YES

Mechanism of Action

Ezetimibe reduces blood cholesterol by inhibiting the absorption of cholesterol by the small intestine, leading to a decrease in the delivery of intestinal cholesterol to the liver. This causes a reduction of hepatic cholesterol stores and an increase in clearance of cholesterol from the blood; this distinct mechanism is complementary to that of statins and of fenofibrate.

Zetia Indications

Indications

In combination with a statin, or alone when additional LDL-C lowering therapy is not possible, as an adjunct to diet to reduce elevated LDL-C in adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH). In combination with a statin as an adjunct to diet to reduce elevated LDL-C in pediatric patients ≥10yrs with HeFH. In combination with fenofibrate as an adjunct to diet to reduce elevated LDL-C in adults with mixed hyperlipidemia. In combination with a statin, and other LDL-C lowering therapies, to reduce elevated LDL-C levels in adults and in pediatric patients aged ≥10yrs with homozygous familial hypercholesterolemia (HoFH). As an adjunct to diet for the reduction of elevated sitosterol and campesterol levels in adults and in pediatric patients ≥9yrs with homozygous familial sitosterolemia.

Zetia Dosage and Administration

Adult

≥10yrs (with hyperlipidemia, HeFH, or HoFH) or ≥9yrs (with homozygous familial sitosterolemia): 10mg once daily. Concomitant bile acid sequestrants: give ezetimibe at least 2hrs before or 4hrs after. 

Children

<10yrs (with HeFH or HoFH) or <9yrs (with homozygous familial sitosterolemia) or those with other hyperlipidemia types: not established.

Zetia Contraindications

Contraindications

The use of ezetimibe in combination with a statin, fenofibrate, or other LDL-C lowering therapy is contraindicated in patients for whom a statin, fenofibrate, or other LDL-C lowering therapy are contraindicated.

Zetia Boxed Warnings

Not Applicable

Zetia Warnings/Precautions

Warnings/Precautions

Risks associated with combination therapy with a statin, fenofibrate, or other LDL-C lowering therapies: refer to the prescribing information of these products. Assess LDL-C when appropriate (as early as 4 weeks after initiation). Increases in serum transaminases (esp. in combination with a statin). Perform liver enzyme testing as clinically indicated; consider ezetimibe withdrawal if increases in ALT/AST ≥3×ULN persist. Risk for myopathy/rhabdomyolysis (esp. in combination with a statin, other agents, or fibrates). Discontinue ezetimibe, other concomitant agents if myopathy is suspected. Moderate to severe hepatic impairment: not recommended. Pregnancy. Nursing mothers: not recommended.

Zetia Pharmacokinetics

Absorption

Mean peak plasma concentrations of 3.4–5.5 ng/mL were reached within 4–12 hours. 

Distribution

Plasma protein bound: >90%.

Metabolism

Hepatic. 

Elimination

Fecal (78%), renal (11%). Half-life: ~22 hours.

Zetia Interactions

Interactions

Concomitant fibrates (except fenofibrate): not recommended. Concomitant fenofibrate; consider alternative lipid-lowering therapy if cholelithiasis is suspected. Potentiates and potentiated by cyclosporine; monitor levels. Antagonized by bile acid sequestrants (eg, cholestyramine). Separate ezetimibe dosing at least 2hrs before or 4hrs after cholestyramine.

Zetia Adverse Reactions

Adverse Reactions

Upper respiratory tract infection, diarrhea, arthralgia, sinusitis, pain in extremity, fatigue, influenza; rare: myopathy/rhabdomyolysis; w. statin: nasopharyngitis, myalgia, back pain, increased serum transaminases.

Zetia Clinical Trials

See Literature

Zetia Note

Notes

For more information on statins, see their entries.

Zetia Patient Counseling

See Literature