Ezetimibe/atorvastatin

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Ezetimibe/atorvastatin (brand name Liptruzet) is a cholesterol lowering combination drug. In the United States, it was approved in May 2013 by the Food and Drug Administration for the treatment of elevated low-density lipoprotein (LDL) in patients with primary or mixed hyperlipidemia as adjunctive therapy to diet.[1] Liptruzet has also been approved to reduce elevated total cholesterol and elevated LDL in patients diagnosed with homozygous familial hypercholesterolemia as an adjunctive treatment to other hyperlipidemia treatments. [2]

Some cardiologists opposed the approval, because the combination reduced LDL cholesterol in a clinical trial, but it did not reduce heart disease. A clinical trial studying the endpoints of heart attacks, strokes and heart-related deaths is scheduled to conclude in 2014.[3]


Mechanism of Action

This combination drug works to reduce cholesterol levels through two different pathways. The ezetimibe component of the medication works by inhibiting cholesterol absorption from food while the atorvastatin component inhibits intrinsic cholesterol production in the liver. [4]

Safe Use

  • Liptruzet is not safe to use in patients with active liver disease or unexplained persistent elevations in hepatic transaminase.
  • Women that are pregnant or may become pregnant should not use Liptruzet. Liptruzet is a teratogenic agent that may disrupt the growth and development of a fetus. Immediate discontinuation of Liptruzet is recommended in patients that become pregnant while taking this drug.

Commonly Reported Adverse Reactions

  • Musculoskeletal pain [5]
  • Elevated liver enzymes (AST and ALT) [6]
  • Gastrointestinal problems such as abdominal pain and nausea [7]

References

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  1. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  2. ↑ 2. "Liptruzet." CenterWatch. Web. 28 Oct. 2014.
  3. ↑ Drug to Cut Cholesterol Is Approved by the F.D.A. By KATIE THOMAS, New York Times, May 3, 2013
  4. ↑ Liptruzet [package insert]. Whitehouse Station, NJ: Merck&Co; 2013
  5. ↑ Merck Sharp & Dohme Corp. Ezetimibe and Atorvastatin vs. Atorvastatin in Patients Age 65 and Older at High Risk for Coronary Heart Disease (CHD). In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [cited 2014 Oct 28]. Available from: http://clinicaltrials.gov/show/NCT00418834 NLM Identifier: NCT00418834
  6. ↑ Merck Sharp & Dohme Corp. Ezetimibe and Atorvastatin vs. Atorvastatin in Patients Age 65 and Older at High Risk for Coronary Heart Disease (CHD). In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [cited 2014 Oct 28]. Available from: http://clinicaltrials.gov/show/NCT00418834 NLM Identifier: NCT00418834
  7. ↑ Merck Sharp & Dohme Corp. Ezetimibe and Atorvastatin vs. Atorvastatin in Patients Age 65 and Older at High Risk for Coronary Heart Disease (CHD). In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [cited 2014 Oct 28]. Available from: http://clinicaltrials.gov/show/NCT00418834 NLM Identifier: NCT00418834
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