Ezetimibe and Muscle-Related Adverse Effects
Muscle-Related Side Effects of Ezetimibe
- Ezetimibe has been associated with cases of myopathy and rhabdomyolysis, both when used alone and in combination with statin therapy, according to the American College of Cardiology 1, 2, 3
- The 2022 ACC Expert Consensus specifically lists myopathy as a warning/precaution for ezetimibe use, as recommended by the American College of Cardiology 1
- Common muscle-related adverse effects reported with ezetimibe include myalgia (muscle pain) and arthralgia (joint pain), as noted by the American College of Cardiology 1, 2
- Pain in extremities is also a reported side effect of ezetimibe, according to the American College of Cardiology 1
Monitoring and Management
- Patients taking ezetimibe should be monitored for any muscle-related symptoms, including muscle pain or weakness, as advised by the American College of Cardiology 2
- Patients should also be monitored for muscle twitching or fasciculations, according to the American College of Cardiology 1
- If a patient develops muscle fasciculations while on ezetimibe, the American College of Cardiology recommends evaluating for other causes of fasciculations 1
- Consider temporary discontinuation to assess if symptoms resolve, as suggested by the American College of Cardiology 2
- Unexplained fatigue is also a symptom that should be monitored, according to the American College of Cardiology 1
Important Clinical Considerations
- When prescribing ezetimibe, clinicians should advise patients to report any new muscle symptoms promptly, as recommended by the American College of Cardiology 1
- Consider baseline and follow-up creatine kinase measurements in high-risk patients, according to the American College of Cardiology 1, 2
Special Populations and Drug Interactions
- Fibrates in combination with ezetimibe may increase risk of muscle symptoms, as noted by the American College of Cardiology 1