Drug Interactions of Ezetimibe

Category: Education

Presentation Description

Ezetimibe can interact majorly with Fibrates (Gemfibrozil, Clofibrate, etc) and moderately with Bile acid sequestrants (Cholestyramine, Colestipol, Colesevelam), Warfarin and Cyclosporine.


Presentation Transcript

Drug Interactions of Antihyperlipidemics Part 5 (Drug Interactions of Ezetimibe):

Drug Interactions of Antihyperlipidemics Part 5 ( Drug Interactions of Ezetimibe ) D r . P.Naina Mohamed P h D P harmacologist


Introduction An adverse drug interaction is defined as an interaction between one or more coadministered medications which leads to decreased therapeutic efficacy or elevated risk of toxicity of any of the coadministered medications. Drug interactions can be caused by P rescription and Over-the-counter (OTC) medications, herbal products or vitamins, foods, diseases, and genetics (family history). It is estimated that people over 65 take an average of seven drugs at any one time to treat a variety of illnesses including higher cholesterol, diabetes, hypertension, etc. With this amount of medicine use, the probability that a person will take two prescribed drugs that may interact with one another is very high.


Antihyperlipidemics Statins (HMG CoA Reductase Inhibitors) Fibrates Bile acid S equestrants Niacin Ezetimibe Lomitapide Orlistat

Ezetimibe & Fibrates:

Ezetimibe & Fibrates Coadministration of Ezetimibe and a Fibrate except fenofibrate , is not recommended. https:// www.merck.com/product/usa/pi_circulars/z/zetia/zetia_pi.pdf

Ezetimibe & Bile Acid Sequestrants :

Ezetimibe & Bile Acid Sequestrants To minimize reductions in ezetimibe bioavailability, Ezetimibe should be administered at least two hours before or four hours after Bile acid sequestrants . https :// www.merck.com/product/usa/pi_circulars/z/zetia/zetia_pi.pdf

Ezetimibe & Warfarin:

Ezetimibe & Warfarin Frequent monitoring of PT/INR is recommended, if ezetimibe and warfarin are used concomitantly. Warfarin dosage should be adjusted accordingly. http:// link.springer.com/article/10.1007/s00380-016-0832-z

Ezetimibe & Cyclosporine:

Ezetimibe & Cyclosporine Monitor for signs and symptoms of ezetimibe toxicity including abdominal, back or headache pain, fatigue, diarrhea, sinusitis, and cough. http :// aop.sagepub.com/content/39/9/1561.full


Conclusion The occurrence of significant morbidity and mortality can be reduced by minimizing the risk for drug interactions. The hyperlipidemic patients should bring a list of all the drugs they are taking including prescription drugs, over-the-counter drugs, and any supplements, herbal or otherwise, during their visit to the doctor or pharmacist . The risk of adverse effects could be reduced and the quality of life for patients improved by healthcare professionals through the screening , education, and follow up on suspected drug interactions. If possible, the hyperlipidemic patients are recommended to fill all their prescriptions at one pharmacy.


References Stockley’s Drug Interactions, 9e Karen Baxter Hurst's The Heart, 13e Valentin Fuster , Richard A. Walsh, Robert A. Harrington Basic & Clinical Pharmacology, 12e Bertram G. Katzung , Susan B. Masters, Anthony J. Trevor http :// www.micromedexsolutions.com

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