Adult Dosing
Primary hyperlipidemia
- Starting dose: 10 mg/20 mg (ezetimibe/simvastatin) PO qpm, may adjust the dose q2 wks
- Note: 10 mg/40 mg (ezetimibe/simvastatin) PO qpm, if larger reduction in LDL-C (>55%) is required
- Max: [10 mg/80 mg]/day
Homozygous Familial Hypercholesterolemia
- Starting dose: 10 mg/40 mg (ezetimibe/simvastatin) PO qpm, may adjust the dose q2 wks
- Note: May convert from simvastatin monotherapy at same dose
- Max: [10 mg/80 mg]/day
Pediatric Dosing
- Note: Safety and effectiveness in pediatric patients <10 yrs have not been established
Heterozygous Familial Hypercholesterolemia (10-17 yrs)
- Start: 10 mg/10 mg (ezetimibe/simvastatin) PO qpm
- Max: [10 mg/40 mg]/day
[Outline]
See Supplemental Patient Information
- Myopathy manifested as muscle pain, tenderness or weakness with creatine kinase above 10 x ULN, sometimes resulting into rhabdomyolysis with or without acute renal failure secondary to myoglobinuria, and rare fatalities, have been reported with ezetimibe/simvastatin
- The risk of myopathy/rhabdomyolysis is dose related, discontinue the treatment immediately if myopathy is diagnosed or suspected. Monitor creatine kinase prior to starting simvastatin therapy or when dose is being increased
- Immune-mediated necrotizing myopathy (IMNM) characterized by proximal muscle weakness and elevated serum creatine kinase has been reported with statin use, and may persist despite discontinuation of statin treatment
- Advanced age (
65 years), uncontrolled hypothyroidism, and renal impairment are the predisposing factors for myopathy - Asymptomatic elevations (3 x ULN) in serum transaminases has been reported with ezetimibe/simvastatin therapy, monitor LFT before the initiation of treatment and periodically thereafter. Discontinue the therapy with ezetimibe/simvastatin if persistent increase in AST or ALT of 3 X ULN or greater
Cautions: Use cautiously in
Supplemental Patient Information
- Women of childbearing age should be advised to use an effective method of contraception to prevent pregnancy during the therapy, and if the patient become pregnant during the therapy, they should discontinue the therapy and consult their health care professional
Pregnancy Category:X
Breastfeeding: Safety unknown; No published data on the use of ezetimibe and simvastatin during breastfeeding. It is best not use during breastfeeding as a concern with disruption of infant lipid metabolism. Ezetimibe in combination with a statin (e.g., atorvastatin, simvastatin) should be avoided in nursing mothers. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 18 February 2011). Because of the potential for serious adverse reactions in nursing infants, manufacturer suggests not to use ezetimibe/simvastatin during breastfeeding.
US Trade Name(s)
US Availability
Vytorin (ezetimibe/simvastatin)
- TABS:
- 10 mg/10 mg
- 10 mg/20 mg
- 10 mg/40 mg
- 10 mg/80 mg
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Inegy (ezetimibe/simvastatin)
- TABS:
- 10 mg/20 mg
- 10 mg/40 mg
- 10 mg/80 mg
Australian Trade Name(s)
Australian Availability
Vytorin (ezetimibe/simvastatin)
- TABS:
- 10 mg/10 mg
- 10 mg/20 mg
- 10 mg/40 mg
- 10 mg/80 mg
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Vytorin 10-40 MG TABS [Bottle] (MERCK/SCHERING-PLOUGH PHARM)
30 mg = $146
90 mg = $419.99 - Vytorin 10-80 MG TABS [Bottle] (MERCK/SCHERING-PLOUGH PHARM)
30 mg = $144.99
90 mg = $411.99 - Vytorin 10-10 MG TABS [Bottle] (MERCK/SCHERING-PLOUGH PHARM)
30 mg = $148.48
90 mg = $422.56 - Vytorin 10-20 MG TABS [Bottle] (MERCK/SCHERING-PLOUGH PHARM)
30 mg = $146
90 mg = $415.99
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.