Fixed-dose Combination Agent Approved to Treat Elevated LDL Cholesterol

October 1, 2004

Ezetimibe/simvastatin (Vytorin)recently became available for thetreatment of high LDL cholesterollevels, as adjunctive therapy to dietarymodification, in patients withprimary hypercholesterolemia ormixed hyperlipidemia. This drug,from Merck/Schering-Plough Pharmaceuticals,inhibits the productionof cholesterol in the liver and blocksthe absorption of cholesterol in theGI tract, including cholesterol obtainedfrom food.

New Agent forCholesterol Reduction

Ezetimibe/simvastatin (Vytorin)recently became available for thetreatment of high LDL cholesterollevels, as adjunctive therapy to dietarymodification, in patients withprimary hypercholesterolemia ormixed hyperlipidemia. This drug,from Merck/Schering-Plough Pharmaceuticals,inhibits the productionof cholesterol in the liver and blocksthe absorption of cholesterol in theGI tract, including cholesterol obtainedfrom food.

The recommended startingdosage is 10 mg ezetimibe/20 mgsimvastatin once a day. Limit themaximum dosage to 10/10 mg dailyfor patients taking cyclosporine and10/20 mg daily for patients takingamiodarone or verapamil.

The most common side effectsare headache, upper respiratorytract infection, myalgia, influenza,and extremity pain. Advise patientsto report muscle pain, tenderness, orweakness to a health care providerpromptly. This agent should be discontinuedif myopathy is reported.