Lipid-Lowering Agent
Pregnancy: Avoid — insufficient data; statins contraindicated so combination also avoided
Ezetimibe
Brand names: Ezetrol
Adult dose
Dose: 10 mg
Route: Oral
Frequency: Once daily
Max: 10 mg/day
Used as monotherapy if statin intolerant, or add-on to statin if LDL target not met. Can be taken at any time of day.
Paediatric dose
Route: Oral
Frequency: Once daily
Max: 10 mg/day
10 mg once daily in children ≥10 years with familial hypercholesterolaemia under specialist guidance.
Dose adjustments
Renal
No dose adjustment required.
Hepatic
Avoid in moderate-to-severe hepatic impairment.
Clinical pearls
- IMPROVE-IT trial: ezetimibe added to simvastatin reduced major CV events post-ACS
- Inhibits NPC1L1 transporter in gut — mechanism distinct from statins
- NICE recommends ezetimibe if LDL target not achieved on max tolerated statin
Contraindications
- Moderate to severe hepatic impairment
Side effects
- Abdominal pain
- Diarrhoea
- Headache
- Myalgia (rare when combined with statin)
Interactions
- Ciclosporin (increases ezetimibe levels)
- Fibrates (increased risk of cholelithiasis)
- Bile acid sequestrants (give ezetimibe ≥2 hours before or 4 hours after)
Monitoring
- Fasting lipid profile at 3 months
Reference: BNFc; BNF 90; NICE NG185; IMPROVE-IT Trial (NEJM 2015). Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators