Abstract
Ezetimibe - a blocker of the absorption of cholesterol and plant sterols from the intestine and intrahepatic bile ducts - is considered an effective and safe possibility of further enhancing the effect of statins on blood lipid levels, especially LDL-cholesterol (LDL-C). It is a well-tolerated medication with very few side effects and can be used in combination with all available statins to achieve the desired LDL-C target levels.
As a single agent, ezetimibe is known to reduce LDL-c levels by approximately 20%, while in combination with a statin, the reduction may be as high as twofold. As with statins, prescription of ezetimibe is based on evidence from clinical trials, especially the IMPROVE-IT study which has shown the greatest benefit of its use is in the high-risk patients, especially in those with type 2 diabetes mellitus.
In general, ezetimibe is useful where LDL-C target levels cannot be achieved with the maximum dose or the maximum tolerated dose of statins. The prescription of ezetimibe has now been approved for all medical specialties, including general practitioners, therefore a gradual increase of its use may be expected since it has frequently been a little appreciated lipid-lowering drug until now.