Ezetimibe + Atorvastatin - Oral

Ezetimibe and Atorvastatin are combined in this medicine.

Ezetimibe + Atorvastatin helps lower your cholesterol and triglyceride (fat) levels in the blood.

Excessive cholesterol and triglycerides in your body can clog up your blood vessels. This can lead to many health problems such as stroke and heart diseases, including heart attack.

This medicine is meant to be taken as part of a complete cholesterol management programme that should include exercise, a healthy diet and lifestyle.

Ezetimibe + Atorvastatin may be used to treat other conditions as decided by your doctor.

Take Ezetimibe + Atorvastatin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

You may take this medicine with or without food. Try to take it at the same time each day.

Ezetimibe + Atorvastatin must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have active liver disease or unexplained abnormal blood tests for liver function as Ezetimibe + Atorvastatin may not be suitable for you.

Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with Ezetimibe + Atorvastatin, alert your doctor immediately. This medicine may cause harm to your unborn child. You must use proven birth control methods while taking Ezetimibe + Atorvastatin.

Do not breastfeed while you are being treated with this medicine.

Do not take Ezetimibe + Atorvastatin with glecipravir/pibrentasvir combination (medicine for hepatitis C infection).

Inform your doctor if you have the following conditions:

• underactive thyroid gland
• recent stroke
• diabetes
• history of liver disease
• kidney disease

Be sure to check with your doctor or pharmacist before giving Ezetimibe + Atorvastatin to the elderly. Elderly people may be more sensitive to the side effects.

Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.

If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.

Some genetic traits can increase your risk of side effects from this medicine. If you have an alteration in a gene called SLCO1B1, you are more likely to develop persistent muscle or joint pain, muscle cramps, numbness or weakness from Ezetimibe + Atorvastatin. Although not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor. However, you may still develop muscle problems even if you do not have this gene type. Inform your doctor immediately if you experience muscle pain, weakness or tenderness, especially if it is accompanied by fever or general body discomfort.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. liver function, blood cholesterol levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring of signs and symptoms of muscle problems may also be needed.

What lifestyle changes should I make to reduce my cholesterol levels?

A healthy, balanced diet and regular exercise are keys to helping you reduce your cholesterol levels. Try to control the type and amount of food that you eat each meal. Include lots of fruits and vegetables in your diet, and avoid eating fried foods or foods that are high in fat. If you have not been exercising, start slow and gradually step up your exercise capacity.

Ezetimibe + Atorvastatin may cause any of the following side effects: headache, dizziness, diarrhoea, nausea, back pain, and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• persistent muscle or joint pain, muscle cramps, weakness or numbness
• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• pain or difficulty in passing urine, change in how much urine is passed, blood in the urine

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Ezetimibe + Atorvastatin with glecipravir/pibrentasvir combination (medicine for hepatitis C infection).

Inform your doctor and pharmacist if you are taking any of these medicines:

• other cholesterol-lowering medicines e.g. gemfibrozil, niacin
• medicines for HIV infection e.g. fosamprenavir, nelfinavir, efavirenz
• other medicines for hepatitis C infection e.g. boceprevir, elbasvir
• certain antibiotics e.g. clarithromycin, erythromycin
• medicines to treat fungal infection e.g. itraconazole, fluconazole
• birth control pills e.g. norethisterone, ethinylestradiol
• rifampicin (medicine to treat TB [lung infection known as tuberculosis])
• digoxin (medicine for irregular heartbeat)
• St. John's wort (herbal medicine)

This list does not include all medicines that may interact with Ezetimibe + Atorvastatin.

Do not take Ezetimibe + Atorvastatin with colestyramine (other cholesterol-lowering medicine). Colestyramine may reduce the effectiveness of this medicine when taken at the same time. If you are taking colestyramine, take Ezetimibe + Atorvastatin at least 2 hours before or 4 hours after your colestyramine dose.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol. Consuming large amount of alcohol is very damaging to the liver.

Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).

Store in a cool, dry place away from the reach of children.

Protect from light and moisture.

Medicines must not be used past the expiry date.