Ezetimibe selectively inhibits cholesterol absorption in the small intestine by targeting the NPC1L1 protein. This mechanism lowers LDL cholesterol and ApoB, key causal drivers of atherosclerosis. Reducing lifelong atherosclerotic cardiovascular disease (ASCVD) risk is a cornerstone of healthspan extension.
Verdict
A well-tolerated, effective non-statin for lowering ApoB and ASCVD risk.
HEALTHSPAN IMPACT
High Value
RISK LEVEL
Moderate
EVIDENCE GRADE
A
MONTHLY COST
$10 - $40
Protocol
- Typically 10 mg taken orally once daily, often in combination with a statin.
Flags
- Rare but possible side effects include myalgia (muscle pain), diarrhea, and fatigue.
- Infrequent elevations in liver enzymes can occur, especially when co-administered with a statin.
- May interact with cyclosporine, fibrates (increasing gallstone risk), and cholestyramine.
- Not recommended during pregnancy or breastfeeding.