Ezetimibe and Simvastatin are combined in this medicine.
Ezetimibe + Simvastatin helps lower your cholesterol and triglyceride (fat) levels in the blood.
Excessive cholesterol and triglycerides in your body can clog up your blood vessels. This can lead to many health problems such as stroke and heart diseases, including heart attack.
Ezetimibe + Simvastatin is meant to be taken as part of a complete cholesterol management programme that should include exercise, a healthy diet and lifestyle.
This medicine may be used to treat other conditions as decided by your doctor.
Take Ezetimibe + Simvastatin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. It is best to take it in the evening. Try to take it at the same time each day.
Ezetimibe + Simvastatin must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
It may be necessary for you to take this medicine for a long time, such as for a few years. Your doctor will advise you on the treatment timeframe.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- liver disease
- severe kidney disease
as Ezetimibe + Simvastatin may not be suitable for you.
Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with this medicine, alert your doctor immediately. Ezetimibe + Simvastatin may cause harm to your unborn child. You must use proven birth control methods while taking this medicine.
Do not breastfeed while you are being treated with this medicine.
Do not take Ezetimibe + Simvastatin with certain antibiotics, certain medicines used in organ transplant or immune disorders; medicines used to treat fungal infections, HIV infection, hepatitis C (viral infection in the liver), depression, and endometriosis (abnormal growth of tissues outside the womb), and other cholesterol-lowering medicines. Please see the section "Can I take this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- thyroid problems
- personal or family history of muscle disorder
- history of muscle toxicity with the use of statins or fibrates (cholesterol-lowering medicines)
- history of liver disease
- diabetes
Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.
Be sure to check with your doctor or pharmacist before giving this medicine to a child, the elderly, or those of Asian ancestry, particularly those of Chinese descent. They may be more sensitive to the side effects.
If you are going for an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking Ezetimibe + Simvastatin.
Some genetic traits can increase your risk of side effects from this medicine. If you have an alteration in your gene called
SLCO1B1, you are more likely to develop persistent muscle or joint pain, muscle cramps, numbness or weakness from Simvastatin. Your doctor may perform genetic testing before giving you this medicine. If you know you have this gene type, inform your doctor. However, you may still develop muscle problems, even if you do not have this gene type. Monitor for signs of muscle or joint pain or weakness and let your doctor know immediately.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if this medicine is suited for you to take.
- Routine tests (e.g. liver function, cholesterol/creatine kinase levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring of signs and symptoms of rhabdomyolysis (abnormal muscle breakdown that can cause kidney damage) may also be needed.
What lifestyle changes should I make to reduce my cholesterol levels?
A healthy, balanced diet and regular exercise are keys to help you reduce your cholesterol levels. Try to control the type and amount of food that you eat each meal. Include lots of fruits and vegetables in your diet, and avoid eating fried foods or foods that are high in fat. If you have not been exercising, start slow and gradually step up your exercise capacity.
Ezetimibe + Simvastatin may cause any of the following side effects: headache, dizziness, diarrhoea, abdominal pain, stomach wind, indigestion, constipation, tiredness, rash, and itching.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- unexplained muscle pain, tenderness or weakness
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Ezetimibe + Simvastatin if you are taking any of these medicines:
- medicines to treat fungal infection e.g. itraconazole, ketoconazole, posaconazole, voriconazole
- certain antibiotics e.g. erythromycin, clarithromycin, telithromycin, fusidic acid
- medicines for HIV infection e.g. cobicistat, nelfinavir
- medicines for hepatitis C infection e.g. boceprevir, telaprevir
- nefazodone (medicine to treat depression)
- gemfibrozil (cholesterol-lowering medicine)
- ciclosporin (medicine used in organ transplant or certain immune disorders)
- danazol (medicine used to treat an abnormal growth of tissues outside the womb)
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines for high blood pressure or heart disease e.g. amlodipine, amiodarone, verapamil, diltiazem, ranolazine, dronedarone
- colchicine (medicine for high uric acid in the blood)
- daptomycin (antibiotic)
- blood-thinning medicines e.g. warfarin, ticagrelor
- rifampicin (medicine to treat TB, a lung infection known as tuberculosis)
This list does not include all medicines that may interact with Ezetimibe + Simvastatin.
Colestyramine may reduce the effectiveness of this medicine when taken at the same time. If you are taking colestyramine, take Ezetimibe + Simvastatin at least 2 hours before or 4-6 hours after your colestyramine dose.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
It is important to adhere to the diet prescribed by your doctor.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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