 is a prescription medication used in combination with diet and exercise to treat high cholesterol. It is also used to lower cholesterol in people with homozygous familial hypercholesterolemia (HoFH, a hereditary disorder that causes high cholesterol levels).Vytorin is a single tablet containing two prescription medicines, ezetimibe and simvastatin. Ezetimibe belongs to a group of drugs called cholesterol absorption inhibitors, which block the absorption of cholesterol from the intestines. Simvastatin belongs to a group of drugs called HMG-CoA... "Pin It")
Vytorin Overview
Vytorin (generic: ezetimibe/simvastatin) is a prescription medication used in combination with diet and exercise to treat high cholesterol. It is also used to lower cholesterol in people with homozygous familial hypercholesterolemia (HoFH, a hereditary disorder that causes high cholesterol levels).
Vytorin is a single tablet containing two prescription medicines, ezetimibe and simvastatin. Ezetimibe belongs to a group of drugs called cholesterol absorption inhibitors, which block the absorption of cholesterol from the intestines. Simvastatin belongs to a group of drugs called HMG-CoA reductase inhibitors, also known as statins, which block an enzyme in the body called HMG-CoA reductase. This is a major enzyme involved in making cholesterol in the body.
This medication comes in tablet form and is usually taken once daily, in the evening. Vytorin can be taken with or without food.
Common side effects of Vytorin include headache, muscle pain, and diarrhea.
Uses of Vytorin
Vytorin is a prescription medicine used to lower levels of total cholesterol, LDL (bad) cholesterol, and fatty substances called triglycerides in the blood. In addition, Vytorin raises levels of HDL (good) cholesterol.
Vytorin is also used to lower cholesterol in people with homozygous familial hypercholesterolemia (HoFH, a hereditary disorder that causes high cholesterol levels).
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
Side Effects of Vytorin
See your doctor regularly to check your cholesterol level and to check for side effects. Your doctor should do blood tests to check your liver before you start taking Vytorin and if you have any symptoms of liver problems while you take Vytorin. Call your doctor right away if you have the following symptoms of liver problems:
- feel tired or weak
- loss of appetite
- upper belly pain
- dark urine
- yellowing of your skin or the whites of your eyes
In clinical studies patients reported the following common side effects while taking Vytorin: headache, muscle pain, and diarrhea (see What should I tell my doctor before and while taking Vytorin?).
The following side effects have been reported in general use with Vytorin or with ezetimibe or simvastatin tablets (tablets that contain the active ingredients of Vytorin):
- allergic reactions including swelling of the face, lips, tongue, and/or throat that may cause difficulty in breathing or swallowing (which may require treatment right away), rash, hives; raised red rash, sometimes with target-shaped lesions; joint pain; muscle pain; alterations in some laboratory blood tests; liver problems (sometimes serious); inflammation of the pancreas; nausea; dizziness; tingling sensation; depression; gallstones; inflammation of the gallbladder; trouble sleeping; poor memory; memory loss; confusion; erectile dysfunction; breathing problems including persistent cough and/or shortness of breath or fever.
Tell your doctor if you are having these or any other medical problems while on Vytorin. This is not a complete list of side effects. For a complete list, ask your doctor or pharmacist.
Vytorin Interactions
Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:
- Certain anti-fungal medicines including:
- itraconazole
- ketoconazole
- posaconazole
- HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir, tipranavir, or atazanavir),
- Certain antibiotics, including:
- erythromycin
- clarithromycin
- telithromycin
- nefazodone
- A fibric acid medicine for lowering cholesterol called gemfibrozil
- cyclosporine
- danazol
Taking Vytorin with certain substances can increase the risk of muscle problems. It is especially important to tell your doctor if you take:
- fibric acid derivatives (such as fenofibrate)
- amiodarone (a drug used to treat an irregular heartbeat)
- verapamil, diltiazem, amlodipine, or ranolazine (drugs used to treat high blood pressure, chest pain associated with heart disease, or other heart conditions)
- large quantities of grapefruit juice (more than 1 quart daily)
- colchicine (a medicine used to treat gout)
- voriconazole (an anti-fungal medicine)
- large doses of niacin or nicotinic acid
Tell your doctor if you are taking niacin or a niacin-containing product, as this may increase your risk of muscle problems, especially if you are Chinese.
It is also important to tell your doctor if you are taking coumarin anticoagulants (drugs that prevent blood clots, such as warfarin).
Vytorin Precautions
Vytorin includes a statin medication called simvastatin. Statin medications carry a rare but serious risk of:
- liver damage
- memory loss or confusion
- increase in blood sugar levels (hyperglycemia)
- type 2 diabetes
- immune-mediated muscle breakdown
Certain statins can increase risk of muscle weakness as well. It is important to consult your physician to discuss the benefits and risks associated with using this medication.
Do not take Vytorin if you take:
- Certain anti-fungal medicines including:
- itraconazole
- ketoconazole
- posaconazole
- HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir, tipranavir, or atazanavir),
- Certain antibiotics, including:
- erythromycin
- clarithromycin
- telithromycin
- nefazodone
- A fibric acid medicine for lowering cholesterol called gemfibrozil
- cyclosporine
- danazol
Ask your doctor if you are not sure if your medicine is listed above.
Also do not take Vytorin:
- If you are allergic to ezetimibe or simvastatin, the active ingredients in Vytorin, or to the inactive ingredients.
- If you have active liver disease or repeated blood tests indicating possible liver problems.
- If you are pregnant, or think you may be pregnant, or planning to become pregnant or breastfeeding.
- If you are a woman of childbearing age, you should use an effective method of birth control to prevent pregnancy while using Vytorin.
Vytorin has not been studied in children under 10 years of age.
Vytorin Food Interactions
Grapefruit and grapefruit juice may interact with Vytorin and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.
Inform MD
Tell your doctor right away if you have unexplained muscle pain, tenderness, or weakness while you take Vytorin. Muscle problems, including muscle breakdown, can be serious in some people and rarely cause kidney damage that can lead to death.
The risk of muscle breakdown is greater at higher doses of Vytorin, particularly the 10/80 mg dose.
The risk of muscle breakdown is greater in people 65 years of age and older, females, and people with kidney or thyroid problems.
Taking Vytorin with certain substances can increase the risk of muscle problems. It is especially important to tell your doctor if you take:
- fibric acid derivatives (such as fenofibrate)
- amiodarone (a drug used to treat an irregular heartbeat)
- verapamil, diltiazem, amlodipine, or ranolazine (drugs used to treat high blood pressure, chest pain associated with heart disease, or other heart conditions)
- large quantities of grapefruit juice (more than 1 quart daily)
- colchicine (a medicine used to treat gout)
- voriconazole (an anti-fungal medicine)
- large doses of niacin or nicotinic acid
Tell your doctor if you are taking niacin or a niacin-containing product, as this may increase your risk of muscle problems, especially if you are Chinese.
It is also important to tell your doctor if you are taking coumarin anticoagulants (drugs that prevent blood clots, such as warfarin).
Tell your doctor about all the medicines you take, including any prescription and nonprescription medicines, vitamins, and herbal supplements.
If you have more than 1 doctor, tell all of your doctors that you take Vytorin. This is especially important when they prescribe a new medicine or increase the dose of your other medicines.
Tell your doctor about all your medical conditions including allergies.
Tell your doctor if you:
- drink substantial quantities of alcohol or ever had liver problems. Vytorin may not be right for you.
- are pregnant or plan to become pregnant. Do not use Vytorin if you are pregnant, trying to become pregnant or suspect that you are pregnant. If you become pregnant while taking Vytorin, stop taking it and contact your doctor immediately.
- are breast-feeding. Do not use Vytorin if you are breast-feeding.
Tell other doctors prescribing a new medication that you are taking Vytorin.
Vytorin and Pregnancy
Tell your doctor if you are pregnant or plan to become pregnant. Do not use Vytorin if you are pregnant, trying to become pregnant or suspect that you are pregnant. If you become pregnant while taking Vytorin, stop taking it and contact your doctor immediately.
Vytorin and Lactation
Tell your doctor if you are breastfeeding. Do not use Vytorin if you are breastfeeding. It is not known if Vytorin is excreted in human breast milk or if it will harm your nursing baby.
Vytorin Usage
- Take Vytorin exactly as your doctor tells you to take it.
- Take Vytorin once a day, in the evening, with or without food.
- If you miss a dose, do not take an extra dose. Just resume your usual schedule.
- Continue to follow a cholesterol-lowering diet while taking Vytorin. Ask your doctor if you need diet information.
- Keep taking Vytorin unless your doctor tells you to stop. If you stop taking Vytorin, your cholesterol may rise again.
Vytorin Dosage
Take Vytorin exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.
The usual dosage range is 10/10 mg/day to 10/40 mg/day. The recommended usual starting dose is 10/10 mg/day or 10/20 mg/day. Vytorin should be taken as a single daily dose in the evening, with or without food.
Due to the increased risk of myopathy (muscle disease), including rhabdomyolysis, particularly during the first year of treatment, use of the 10/80-mg dose of Vytorin should be restricted to patients who have been taking Vytorin 10/80 mg chronically (e.g., for 12 months or more) without evidence of muscle toxicity.
Taking Vytorin with other medicines:
- Patients taking Verapamil or Diltiazem: the dose of Vytorin should not exceed 10/10 mg/day.
- Patients taking Amiodarone, Amlodipine or Ranolazine: the dose of Vytorin should not exceed 10/20 mg/day.
- Patients taking Bile Acid Sequestrants (cholestyramine (Locholest light, Locholest, Prevalite), colestipol (Colestid, Flavored Colestid ), and colesevelam (Welchol) : dosing of Vytorin should occur either ≥2 hours before or ≥4 hours after administration of a bile acid sequestrant.
Vytorin Overdose
If you take too much Vytorin contact your doctor right away or call your local Poison Control Center.
Forms of Vytorin
Vytorin tablets are available in the following strengths: 10/10 mg, 10/20 mg, 10/40 mg and 10/80 mg.
Active ingredients: ezetimibe, simvastatin.
Inactive ingredients: Butylated hydroxyanisole NF, citric acid monohydrate USP, croscarmellose sodium NF, hypromellose USP, lactose monohydrate NF, magnesium stearate NF, microcrystalline cellulose NF, and propyl gallate NF.
Other Requirements
Store this medicine at room temperature away from excess heat and moisture. Keep this and all medicines out of the reach of children.
