vytorin

Vytorin contains a combination of ezetimibe and simvastatin. Ezetimibe reduces the amount of cholesterol absorbed by the body. Simvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins."

Ezetimibe and simvastatin reduce the blood levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).

Vytorin is used together with a low-fat diet and other treatments to lower total cholesterol in adults and children who are at least 10 years old. It is not known whether Vytorin reduces your risk of heart disease.

Vytorin may also be used for purposes not listed in this medication guide.

Important information

You should not use Vytorin if you have active liver disease or abnormal liver function tests.

The following drugs should not be used while you are taking Vytorin: boceprevir, cyclosporine, danazol, gemfibrozil, nefazodone, telaprevir, certain antibiotics (clarithromycin, erythromycin, telithromycin), antifungal medication (itraconazole, ketoconazole, posaconazole, voriconazole), or certain HIV/AIDS medication (atazanavir, cobicistat (Stribild, Tybost), indinavir, nelfinavir, ritonavir, saquinavir, tipranavir).

Do not use Vytorin if you are pregnant or if you could become pregnant. Use effective birth control.

Do not breast-feed while using Vytorin.

Before taking this medicine

You should not use Vytorin if you are allergic to simvastatin (Zocor) or ezetimibe (Vytorin, Zetia), or if you have:

• active liver disease;

• abnormal liver function tests; or

• if you are pregnant or breast-feeding.

The following drugs can increase your risk of serious muscle problems if you take them together with Vytorin. These drugs should not be used while you are taking simvastatin:

• cyclosporine;

• danazol;

• gemfibrozil;

• nefazodone;

• an antibiotic - clarithromycin, erythromycin, telithromycin;

• antifungal medication - itraconazole, ketoconazole, posaconazole, voriconazole;

• hepatitis C medications - boceprevir, telaprevir; or

• >HIV/AIDS medication - atazanavir, cobicistat (Stribild, Tybost), indinavir, nelfinavir, ritonavir, saquinavir, tipranavir.

Before you start taking Vytorin, tell your doctor if you are already using any of these other medicines:

• amiodarone;

• amlodipine (sometimes in combination medicines - Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide);

• diltiazem;

• dronedarone;

• ranolazine; or

• verapamil.

To make sure Vytorin is safe for you, tell your doctor if you have:

• a thyroid disorder;

• a history of liver or kidney disease;

• a history of liver problems caused by alcohol;

• low blood pressure;

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

• untreated or uncontrolled seizures;

• if you drink large amounts of alcohol;

• if you are older than 65; or

• if you are of Chinese descent.

FDA pregnancy category X. Vytorin can harm an unborn baby or cause birth defects. Do not take Vytorin if you are pregnant. Use effective birth control. Stop using the medicine and tell your doctor right away if you become pregnant.

See also: Pregnancy and breastfeeding warnings (in more detail)

It is not known whether ezetimibe and simvastatin passes into breast milk or if it could harm a nursing baby. Do not breast-feed while using this medicine.

How should I take Vytorin?

Take Vytorin exactly as prescribed. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

While using this medicine, you may need frequent blood tests.

If you have major surgery or a severe injury or infection, make sure any doctor caring for you knows you are taking Vytorin.

Vytorin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

Grapefruit and grapefruit juice may interact with this medicine and lead to unwanted side effects. Avoid the use of grapefruit products while taking Vytorin.

If you also take cholestyramine, colesevelam, or colestipol: Space your doses apart in order to take Vytorin either 2 hours before or 4 hours after you take any of these other medications.

Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage.

Avoid eating foods that are high in fat or cholesterol. Vytorin will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.

Vytorin side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Vytorin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, simvastatin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

Stop using this medicine and call your doctor at once if you have:

• little or no urinating, pain in your side or lower back;

• swelling, rapid weight gain;

• nausea, upper stomach pain, loss of appetite, unusual tiredness; or

• dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common Vytorin side effects may include:

• headache;

• diarrhea; or

• cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Vytorin?

Many drugs can interact with Vytorin. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with Vytorin, especially:

• colchicine;

• lomitapide;

• fenofibrate, fenofibric acid;

• a blood thinner (warfarin, Coumadin, Jantoven);

• heart rhythm medicine - amiodarone or dronedarone;

• a>heart or blood pressure medicine - amlodipine, diltiazem, ranolazine, verapamil; or

• medicines that contain niacin, or vitamin B3, such as Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others.

This list is not complete and many other drugs can cause serious or life-threatening medical problems if used together with Vytorin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.