Adverse effects and precautions

• headache, abdominal pain and diarrhoea are commonly reported by patients taking ezetimibe (1)
• hypersensitivity reactions have been reported rarely - including angioedema and rash,
• in comparative studies with ezetimibe plus a statin with a statin alone - the overall incidence of unwanted effects was not significantly different between the groups
  • note however, in one study, 2% of patients randomised to a statin plus ezetimibe developed asymptomatic increases in plasma levels of liver enzymes compared with none of those taking ezetimibe, a statin or placebo alone (1)
• ...ezetimibe did not appear to reduce the absorption of fat-soluble vitamins (1)
• no adjustment of the dose of ezetimibe is needed for older patients, patients with renal impairment or those with mild liver dysfunction
  • note however that the manufacturer does not advise the use of ezetimibe in patients with moderate or severe liver disease (Child-Pugh score 7 or more)

Reference:

1. Drug and Therapeutics Bulletin 2004; 42(9):65-7.