How to use
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ezetimibe and simvastatin combination, the following should be considered:
Allergies?Tell your doctor if you have ever had any unusual or allergic reaction to ezetimibe or simvastatin. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy?Ezetimibe and simvastatin should not be used during pregnancy or by women who plan to become pregnant . This medicine blocks formation of cholesterol, which is necessary for the fetus to develop properly. This medicine may cause birth defects or other problems in the baby if taken during pregnancy. An effective form of birth control should be used during treatment with these medicines. Check with your doctor immediately if you think you have become pregnant while taking this medicine. Be sure you have discussed this with your doctor.
Breast-feeding?It is not known if ezetimibe and simvastatin passes into breast milk. However, it should not be used during breast-feeding because it may cause serious unwanted effects in nursing babies.
Children?This medicine has been tested in children and, in effective doses, has not been shown to cause different side effects or problems than it does in adults. This medicine should only be used in children 10 years of age or older.
Older adults?This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults
Other medicines?Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ezetimibe and simvastatin, it is especially important that your doctor and pharmacist know if you are taking any of the following:
Alcohol?May cause liver problems and should not be used while taking ezetimibe and simvastatin.
Amiodarone (e.g., Cordarone) or
Verapamil (e.g., Calan)?May increase your risk of serious side effects.
Cyclosporine (e.g., Sandimmune)?May increase the amount of ezetimibe in your blood.
Clarithromycin (e.g., Biaxin) or
Erythromycin (e.g., Erythrocin) or
Grapefruit juice (large amounts) or
HIV protease inhibitors (e.g., Reyataz, Viracept) or
Itraconazole (e.g., Sporanox) or
Ketoconazole (e.g., Nizoral). or
Nefazodone (e.g., Serzone)?May increase your risk of serious side effects.
Fibric Acid Derivatives, such as
Fenofibrate (e.g., Tricor) or
Gemfibrozil (e.g., Lopid)?May increase your risk of serious side effects.
Niacin (nicotinic acid) in lipid-lowering doses?Use of these medicines with ezetimibe and simvastatin may increase the risk of developing muscle problems (causing the release of muscle pigment into the urine) that may lead to kidney failure
Warfarin?May increase risk of side effects; prothrombin time should be monitored for changes.
Other medical problems?The presence of other medical problems may affect the use of ezetimibe and simvastatin. Make sure you tell your doctor if you have any other medical problems, especially:
Liver disease (or history of) or
Liver enzymes, persistently high levels?Use of this medicine may make liver problems worse
Major surgery or serious illness?May increase chance of kidney side effects
Complicated medical histories or
Diabetes mellitus (sugar diabetes) or
Kidney disease?May increase risk of muscle side effects
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