Ezetimibe and Simvastatin e-ZET-e-mibe and SIM-va-stat-in is used to lower cholesterol and triglyceride fat-like substances levels in the blood. Using this medicine may help prevent medical problems caused by such substances clogging the blood vessels.

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

Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: Incidence not known Abdominal fullness bloating chills constipation darkened urine fast heartbeat fever gaseous abdominal pain hives hoarseness indigestion irritation itching joint pain large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs loss of appetite nausea pains in stomach, side, or abdomen, possibly radiating to the back severe nausea stomach pain rash recurrent fever redness of skin shortness of breath stiffness swelling of eyelids, face, lips, hands, or feet tightness in chest troubled breathing or swallowing vomiting wheezing yellow eyes or skin Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome. Less common Body aches or pain cough diarrhea difficulty in breathing difficulty in moving ear congestion general feeling of discomfort or illness headache loss of voice muscle aches and pains or cramping muscle stiffness nasal congestion pain in arms or legs runny nose shivering sneezing sore throat sweating swollen joints trouble sleeping unusual tiredness or weakness vomiting Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

FOR BEST RESULTS, this medicine should be used along with exercise, a low-cholesterol/low-fat diet, and a weight loss program if you are overweight. FOLLOW THE DIETARY PLAN provided by your doctor. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children and pets. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.

If you miss a dose of this medicine, take it as soon as possible. Do not take more than one dose per day.

To store this medicine: Keep out of the reach of children. Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Keep the medicine from freezing. Do not refrigerate. Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of childr