Zetia with Statins

Although Zetia (ezetimibe) can be used alone it is often prescribed as adjunctive to a statin drug. Zetia by itself is not a statin. Its mechanism of action has to do with reducing the absorption of cholesterol in your digestive tract, including from the food we eat. Zetia has been combined with the statin drug Zocor in the combination pill Vytorin.

I receive many reports of people switched from Zocor to Vytorin for muscle pain with neither the patient nor the doctor suspecting that Vytorin will probably only aggravate the condition.

The adverse drug reports I am now seeing associated with the use of Vytorin relate in part to increased sales but with no small contribution to the additive effect of the two drugs on cholesterol biosynthesis and bio-availability within the body.
Vytorin now has the dubious distinction of causing the greatest number of adverse drug reports seen by me.

There is no doubt that the addition of Zetia to a statin drug is additive in terms of the ultimate effect on cholesterol availability in our bodies but in view of the research evidence showing increasing irrelevance of cholesterol in the process of atherosclerosis, this excessive focus on cholesterol seems misguided and perhaps even ludicrous. The one thing it has done for the parent company of Vytorin is to further the life of its cash cow, Zocor, for Zocor's patent has now expired.

In a clinical trial widely reported by its parent company, people who added Zetia to their statin medication reduced their "Bad Cholesterol" by an additional 25% (36 points). But this has resulted in a near doubling of adverse drug reports from Vytorin compared with Zocor alone and added not a bit of difference to anyone's cardiovascular risk, which many now agree is due to inflammation, not cholesterol.

Cholesterol is one of the most important biochemicals in our bodies, especially for proper central nervous system functioning. Zetia by itself is relatively free of side effects but why bother? Please see my Vytorin side effects page for a list of reader experiences on what Vytorin users can expect. It seems that the addition of Zetia to Zocor has resulted in a product with side effects greater than either drug alone.

Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor

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