atorvastatin + ezetimibe at a glance
Medicine class
A statin combined with a cholesterol-absorption inhibitor
Main role
Lowers cholesterol in adults already controlled with atorvastatin and ezetimibe separately
Food
May be taken with or without food
Important warning
Unexplained muscle pain, tenderness or weakness needs prompt medical advice
What is atorvastatin + ezetimibe used for?
This product is licensed in adults as a fixed-combination substitute for people already adequately controlled with atorvastatin and ezetimibe taken separately.
Primary familial or non-familial hypercholesterolaemia and mixed hyperlipidaemia, alongside diet
Homozygous familial hypercholesterolaemia, alongside diet
Reducing cardiovascular-event risk in people with coronary heart disease and a history of acute coronary syndrome
How does atorvastatin + ezetimibe work?
Ezetimibe blocks the NPC1L1 transporter in the small-intestinal lining, reducing cholesterol absorption. Atorvastatin inhibits HMG-CoA reductase in the liver, reducing cholesterol production and increasing removal of LDL cholesterol from the blood.
atorvastatin + ezetimibe preparations and strengths
Tablet
Route: Oral
Strengths: 10 mg + 10 mg, 10 mg + 20 mg, 10 mg + 40 mg, 10 mg + 80 mg
How to take atorvastatin + ezetimibe
Follow the prescription and pack leaflet. Swallow the film-coated tablet with water. It may be taken with or without food.
Continue the cholesterol-lowering diet recommended by your healthcare team.
If using a bile-acid sequestrant such as colestyramine, check the required separation with a pharmacist or prescriber.
Avoid large quantities of grapefruit juice because they can increase atorvastatin exposure.
Avoid excessive alcohol because it may increase liver-related adverse effects.
atorvastatin + ezetimibe side effects
Common or expected effects
- Diarrhoea
- Muscle aches
- Headache
- Nausea, indigestion, constipation or wind
- Abnormal liver or muscle-enzyme blood tests
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling and breathing difficulty
- Severe blistering or peeling skin reaction
- Myopathy or rhabdomyolysis: marked muscle pain, tenderness or weakness, sometimes with fever or red-brown urine
- Liver injury, which may cause yellow skin or eyes, dark urine or pale stools
- Severe persistent abdominal pain that may indicate pancreatitis
atorvastatin + ezetimibe in pregnancy
This fixed-combination product is contraindicated during pregnancy and should not be used when trying to conceive. If pregnancy occurs, stop taking it and contact the prescriber promptly.
atorvastatin + ezetimibe while breastfeeding
This fixed-combination product is contraindicated during breastfeeding. Individual lipid-lowering medicines may sometimes be considered after specialist risk assessment, so discuss alternatives with the prescriber rather than changing treatment without advice.
atorvastatin + ezetimibe interactions
Check new prescriptions, over-the-counter medicines and supplements with a pharmacist or prescriber because several interactions can increase muscle toxicity or reduce cholesterol lowering.
Systemic fusidic acid
The combination substantially increases the risk of myopathy and rhabdomyolysis and requires medical management.
Strong CYP3A4 or transporter inhibitors
Clarithromycin, itraconazole, some HIV or hepatitis C antivirals, ciclosporin and letermovir can increase atorvastatin exposure and muscle toxicity.
Glecaprevir with pibrentasvir
Use with the fixed combination is contraindicated because atorvastatin exposure may rise substantially.
Common questions about atorvastatin + ezetimibe
Answers are fully visible for fast scanning and source review.
Why are atorvastatin and ezetimibe combined in one tablet?
They lower cholesterol through different pathways. The fixed tablet can replace corresponding separate tablets once treatment is stable.
Can it be taken with food?
Yes. The film-coated tablet may be taken with or without food.
Can I drink grapefruit juice?
Avoid large quantities because grapefruit can increase atorvastatin exposure and adverse effects.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.