Ezetimibe (Ezetrol)

Ezetimibe (Ezetrol) is a cholesterol-lowering drug that acts by decreasing the absorption of cholesterol from the gut. It is used alone or in combination with statin or fibrate drugs to treat primary hypercholesterolemia.

A small study in HIV-positive patients found that ezetimibe can reduce levels of low-density lipoprotein (LDL) cholesterol, with similar efficacy to fluvastatin (Lescol/Lescol XL).1 Adding ezetimibe to pravastatin (Lipostat) in patients with HIV is also effective in reducing LDL cholesterol levels.2

A small study of ezetimibe monotherapy in HIV patients on ART found that the drug was safe and effective, resulting in mean LDL decreases of 5% (11 mg/dl).3 These results were confirmed in a crossover study of ezetimibe monotherapy. This is good news for those who cannot tolerate statin treatment.4

Ezetimibe is available in 10mg tablets, as well as in a combination tablet with simvastatin. This combination was able to reduce LDL cholesterol significantly more than the use of simvastatin alone without producing an increase in side effects. In addition, there was an increase in HDL cholesterol and a decrease in CRP levels over those achieved with simvastatin alone.

Side-effects include headache and diarrhoea, with rare cases of muscle pain, liver toxicity, and hypersensitivity.

References

  1. Coll B et al. Ezetimibe effectively decreases LDL-cholesterol in HIV-infected patients. AIDS 20: 1675-1677, 2006
  2. Negredo E et al. Ezetimibe, a selective inhibitor of cholesterol absorption, as a new strategy for treatment of hypercholesterolemia secondary to antiretroviral therapy. 45th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, abstract H-336, 2005
  3. Wohl DA et al. Ezetimibe alone reduces low-density lipoprotein cholesterol in HIV-infected patients receiving combination antiretroviral therapy. Clin Inf Diseases 47(8):1105–1108, 2008
  4. Wohl DA et al. Ezetimibe was safe and effective in reducing low-density lipoprotein cholesterol and is an option for patients who cannot tolerate treatment with a statin. Clin Infect Dis 47(8): 1105-1108, 2008

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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.