Ezetimibe — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Ezetimibe?
Ezetimibe is a cholesterol absorption inhibitor used to lower LDL cholesterol, either alone or in combination with a statin. This medication is funded by Pharmac under Special Authority as add-on to statin therapy.
What is Ezetimibe Used For?
Ezetimibe is used for primary hypercholesterolaemia as monotherapy (in patients intolerant of statins) or as add-on therapy to a statin in patients not at LDL target. It is also used for homozygous familial hypercholesterolaemia.
How Does Ezetimibe Work?
Ezetimibe inhibits the Niemann-Pick C1-Like 1 (NPC1L1) protein in the small intestinal brush border, blocking the absorption of dietary and biliary cholesterol from the gut. This reduces intestinal cholesterol delivery to the liver, which responds by increasing hepatic LDL receptor expression — lowering plasma LDL cholesterol.
How to Take Ezetimibe
Taken as a single 10 mg tablet once daily, at any time of day with or without food. Can be taken at the same time as a statin for convenience. Full LDL-lowering effect (approximately 15–20% reduction) is seen after 2–4 weeks.
Common Side Effects of Ezetimibe
- Headache
- Fatigue
- Abdominal pain
- Diarrhoea
- Musculoskeletal pain
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Hepatitis (rare — particularly with combined statin therapy)
- Myopathy (rare — more common if combined with statin)
- Severe skin reactions (rare)
Drug Interactions
Ezetimibe may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Statins (additive LDL lowering — generally well tolerated in combination)
- Fibrates (fenofibrate, gemfibrozil — combined with ezetimibe increases gallstone risk)
- Cyclosporin (increases ezetimibe levels)
- Colestyramine (reduces ezetimibe absorption — take ezetimibe at least 2 hours before or 4 hours after)
New Zealand Prescribing Information
Ezetimibe (10 mg tablets — Ezetrol® and generics) is funded by Pharmac under Special Authority as add-on therapy for hypercholesterolaemia when statin therapy alone is insufficient or not tolerated. It provides approximately 15–20% additional LDL reduction on top of a statin. Fixed-dose combinations with simvastatin (Inegy® 10/20, 10/40 mg) are also available.
Frequently Asked Questions
How much does ezetimibe lower cholesterol?
Ezetimibe lowers LDL cholesterol by approximately 15–20% as monotherapy, and by an additional 15–20% when added to a statin (on top of the statin effect). This combined reduction significantly improves LDL target attainment in high-risk patients.
Is ezetimibe as good as a statin?
Statins are generally more potent LDL-lowering agents and have a larger evidence base for cardiovascular risk reduction. Ezetimibe is typically used as an add-on to a statin when the statin alone doesn’t achieve the LDL target, or as an alternative for patients who are truly intolerant of all statins.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: