Meta Information
ID:ezetimibe
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/bile-acid-sequestrants
Target name:
Bile Acid Sequestrants
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
4
Description:
Bile acid sequestrants (e.g., cholestyramine, colestipol) bind to ezetimibe in the intestine, preventing its absorption and significantly reducing its effectiveness.
Actionable advice:
Take ezetimibe at least 2 hours before or 4 hours after taking a bile acid sequestrant.
Target id:
/class/fibrates
Target name:
Fibrates
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining ezetimibe with fibrates (especially gemfibrozil) increases the concentration of cholesterol in the bile, significantly raising the risk of developing gallstones (cholelithiasis).
Actionable advice:
Avoid co-administration with gemfibrozil; use with fenofibrate requires caution and medical supervision.
Target id:
/class/immunosuppressants
Target name:
Cyclosporine (Calcineurin Inhibitor)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Cyclosporine significantly increases the concentration of ezetimibe in the blood, and ezetimibe can slightly increase cyclosporine levels, raising the risk of side effects for both drugs.
Actionable advice:
Avoid co-administration; if necessary, it requires close medical supervision and dose adjustments.
Target id:
/condition/hepatic-impairment
Target name:
Moderate to Severe Liver Disease
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
In people with moderate to severe liver disease, the body's ability to process ezetimibe is impaired, leading to significantly increased drug levels and unknown safety risks.
Actionable advice:
Avoid using ezetimibe if you have moderate to severe liver disease.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The safety of ezetimibe during pregnancy has not been established, and it is generally not recommended due to potential risks to the fetus.
Actionable advice:
Avoid using ezetimibe if you are pregnant or planning to become pregnant.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if ezetimibe passes into breast milk; therefore, its use is generally not recommended while breastfeeding to avoid potential risk to the infant.
Actionable advice:
Avoid using ezetimibe while breastfeeding.
Target id:
/class/statins
Target name:
Statins (HMG-CoA Reductase Inhibitors)
Severity:
major
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Ezetimibe inhibits cholesterol absorption from the gut while statins inhibit cholesterol production in the liver, providing a powerful dual mechanism for lowering LDL cholesterol.
Actionable advice:
Take as prescribed with a statin for enhanced cholesterol-lowering effects.
Target id:
/biomarker/lipid-panel
Target name:
Lipid Panel (LDL-C, ApoB)
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Regular monitoring of your lipid panel is essential to assess the effectiveness of ezetimibe in lowering cholesterol levels.
Actionable advice:
Check your lipid panel 4-12 weeks after starting therapy and then periodically thereafter.
Target id:
/class/anticoagulants-antiplatelets
Target name:
Warfarin and other Vitamin K Antagonists
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Ezetimibe may enhance the anticoagulant effect of warfarin, leading to an increased International Normalized Ratio (INR) and a higher risk of bleeding.
Actionable advice:
Monitor your INR closely when starting, stopping, or changing the dose of ezetimibe.
Target id:
/biomarker/alanine-aminotransferase
Target name:
Liver Enzymes (ALT/AST)
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Ezetimibe, particularly when used with a statin, can rarely cause elevations in liver enzymes, indicating potential liver stress or injury.
Actionable advice:
Obtain baseline liver function tests before starting and monitor as recommended by your doctor.
Target id:
/class/statins
Target name:
Statins (HMG-CoA Reductase Inhibitors)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The combination of ezetimibe and a statin may slightly increase the risk of muscle-related side effects (myopathy) and liver enzyme elevations compared to either drug alone.
Actionable advice:
Report any unexplained muscle pain, tenderness, or weakness to your doctor immediately.
Target id:
/class/antacids
Target name:
Antacids (Aluminum/Magnesium)
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Antacids containing aluminum and magnesium can slightly decrease the rate of ezetimibe absorption, though the overall amount absorbed is not significantly affected.
Actionable advice:
For maximum consistency, separate ezetimibe from antacids by at least 2 hours.
Target id:
/class/viscous-fibers
Target name:
Gel-Forming Viscous Fibers (e.g., Psyllium)
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Thick, gel-forming fibers like psyllium could theoretically bind to ezetimibe in the gut, potentially reducing its absorption and effectiveness.
Actionable advice:
Separate ezetimibe from high-dose viscous fiber supplements by at least 2 hours.
Target id:
/intervention/red-yeast-rice
Target name:
Red Yeast Rice
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Red yeast rice contains monacolin K, a naturally occurring statin, which when combined with ezetimibe may increase the risk of muscle-related side effects (myopathy).
Actionable advice:
Exercise caution and report any muscle pain if combining ezetimibe with red yeast rice.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The absorption of ezetimibe is not significantly affected by food, making it convenient to take at any time of day, with or without a meal.
Actionable advice:
Take ezetimibe at a consistent time each day, either with or without food.
Target id:
/condition/pediatric
Target name:
Pediatric (Children < 10 years)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The safety and effectiveness of ezetimibe have not been established in children younger than 10 years of age.
Actionable advice:
Avoid use in children under 10 years old unless specifically prescribed by a specialist.