Zetia (ezetimibe) is prescribed to lower high cholesterol in adults and some children, along with a low cholesterol diet. It can cause mild side effects and, less commonly, serious side effects.
Zetia is specifically used for high cholesterol caused by:
- primary (familial) hyperlipidemia
- mixed hyperlipidemia
- hom*ozygous familial hypercholesterolemia (HoFH)
For these uses, your doctor may prescribe Zetia along with other medications to reduce high cholesterol levels.
Zetia is also used to reduce blood levels of fats called plant sterols in people with hom*ozygous sitosterolemia.
Zetia is available as a tablet that you take by mouth. It only comes in a strength of 10 milligrams (mg).
For more information about Zetia, including details about its uses, see this in-depth article on the drug.
Some people may develop mild or serious side effects during Zetia treatment. Some side effects are more common than others.
More common side effects in people taking Zetia* include:
- upper respiratory infections, such as colds
- diarrhea
- joint pain
- sinusitis (swelling of the sinuses)
- pain in your arms, legs, hands, or feet
* In studies, these side effects were reported in people who took Zetia by itself. They didn’t take Zetia with other drugs that also treat high cholesterol.
Some people experience mild side effects with Zetia. Examples of mild side effects that have been reported with Zetia include:
- upper respiratory infections, such as colds
- diarrhea
- joint pain
- sinusitis (swelling of the sinuses)
- pain in your arms, legs, hands, or feet
- dizziness*
* To learn more about this side effect, see the “Side effects explained” section below.
In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And do not stop using Zetia unless your doctor recommends it.
Zetia may cause mild side effects other than the ones listed above. See the Zetia prescribing information for details.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Zetia, visit MedWatch.
Less commonly, taking Zetia may lead to serious side effects. Your risk of developing serious side effects may increase if you take Zetia with other medications to treat high cholesterol, such as statin drugs.
Serious side effects can include:
- muscle-related problems, such as leg cramps*
- increased liver enzyme levels*
- allergic reaction*†
* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Zetia. But it’s not clear whether this side effect occurred in studies.
If you develop serious side effects while taking Zetia, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Get answers to some frequently asked questions about Zetia’s side effects.
Are there any reviews or complaints available from people who’ve used Zetia?
Before trying something new, it’s common to look for written reviews about the experiences of others. You may be able to find testimonials online from people who take Zetia.
But reviews and complaints about medications, including Zetia, may not be as reliable as other types of consumer reviews. This is because every person’s body responds differently to medications. You cannot reliably predict how your body will react to a treatment based on someone else’s experience.
To help you decide whether Zetia is a good treatment choice for you, talk with your doctor. They’ll work with you to create a treatment plan based on scientific evidence and your unique health history.
Will stopping Zetia treatment result in any side effects?
Stopping Zetia treatment shouldn’t cause any noticeable side effects. If you and your doctor decide that Zetia treatment isn’t right for you, you simply won’t take any more doses.
But keep in mind that Zetia is used to reduce cholesterol levels in your blood. So stopping Zetia may lead to an increase in your cholesterol levels. If your doctor recommends that you stop taking Zetia, they may suggest another treatment option for your condition.
Can Zetia cause weight gain or weight loss?
Zetia shouldn’t cause weight gain or weight loss. In studies, weight changes didn’t occur in people who took the drug.
Zetia is meant to be used in combination with a diet that’s low in saturated fat and cholesterol. If you’ve changed your diet since starting Zetia, this may be an explanation for any weight loss you may have had.
If you have questions about weight changes while using Zetia, talk with your doctor. They may have suggestions depending on your weight and health goals.
Is memory loss a possible side effect of Zetia?
Memory loss isn’t a side effect of Zetia. It wasn’t reported during studies of the drug.
But some people have reported memory loss, confusion, and forgetfulness while taking a statin drug. Statins are commonly prescribed with Zetia to treat certain types of high cholesterol.
If you’ve noticed memory problems while taking Zetia, talk with your doctor.
Do Zetia’s side effects go away?
Most of Zetia’s side effects should go away within a few days or weeks. But it’s possible that some side effects may continue to affect you for as long as you’re taking the medication.
For example, in studies, some people had to stop taking the drug because their liver enzyme levels increased. After stopping Zetia treatment, their liver enzymes levels went back down.
If you have side effects of Zetia that bother you, talk with your doctor or pharmacist. They’ll guide you with suggestions they may have to relieve these side effects. Or they may recommend that you stop taking the medication.
Learn more about some of the side effects that Zetia may cause.
Muscle-related problems, such as leg cramps
Muscle-related problems are a possible side effect of Zetia when used with other medications. In studies, muscle problems commonly occurred in adults and children who took Zetia with statin drugs. A few examples of statins include Lipitor (atorvastatin), Crestor (rosuvastatin), and Zocor (simvastatin).
Muscle problems are common side effects of statin drugs. Taking Zetia with a statin may cause this side effect.
Muscle-related symptoms may include:
- pain
- weakness or tiredness
- spasms or cramps, such as leg cramps
- stiffness
In rare cases, taking Zetia with a statin drug may cause rhabdomyolysis (muscle breakdown). This is a serious medical condition that, if left untreated, can lead to kidney damage.
What might help
If you develop bothersome muscle pain or other muscle-related symptoms, talk with your doctor. If you’re taking a statin drug with Zetia, they may recommend that you take a supplement called coenzyme Q10 (CoQ10).
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If your muscle-related side effects don’t go away or become severe, tell your doctor right away. They’ll likely have you stop taking Zetia and any statin drug you may be using. They may also check you for signs of muscle breakdown or kidney damage.
Increased liver enzyme levels
Increased liver enzyme levels are a possible side effect of Zetia. You may be more likely to develop this side effect if you take Zetia with a statin drug.
In studies, some people had to stop taking Zetia because of this side effect.
An increase in levels of liver enzymes doesn’t usually cause any symptoms. But it may be a sign that your liver isn’t working as well as it should. Symptoms of liver damage include:
- abdominal (belly) pain
- nausea or vomiting
- dark-colored urine
- light-colored stool
- itching
- yellowing of your skin or the whites of your eyes
What might help
If you have any of the above symptoms of liver damage, tell your doctor right away.
During Zetia treatment, your doctor will likely recommend blood tests. These tests will look at your cholesterol levels and also your liver enzyme levels. If you develop increased liver enzyme levels, your doctor may make changes to your treatment plan.
Dizziness
Dizziness is a rare side effect of taking Zetia. But in studies, some people had to stop taking the drug due to feeling dizzy.
What might help
If you feel dizzy from Zetia, it may help to take your dose at bedtime.
If taking your dose at bedtime doesn’t help, or if dizziness becomes severe, tell your doctor. They’ll likely suggest changes to your treatment plan.
Allergic reaction
Like most drugs, Zetia can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies of the drug.
Symptoms can be mild or serious and can include:
- skin rash
- itching
- flushing (temporary warmth, redness, or deepening of skin color)
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. To manage your symptoms, they may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl (diphenhydramine). Or they may recommend a product you apply to your skin, such as hydrocortisone cream.
If your doctor confirms you had a mild allergic reaction to Zetia, they’ll decide if you should continue using it.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you had a serious allergic reaction to Zetia, they may have you switch to a different treatment.
Keeping track of side effectsDuring your Zetia treatment, consider keeping notes on any side effects you’re having. Then you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.
Your side effect notes can include things such as:
- what dose of drug you were taking when you had the side effect
- how soon after starting that dose you had the side effect
- what your symptoms were from the side effect
- how it affected your daily activities
- what other medications you were also taking
- any other information you feel is important
Keeping notes and sharing them with your doctor will help your doctor learn more about how Zetia affects you. And your doctor can use this information to adjust your treatment plan if needed.
Zetia may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Zetia. The list below includes factors to consider.
Liver problems. If you have liver problems, your liver may not work properly to remove medications such as Zetia from your body. This may increase your risk of side effects. Also, Zetia use may cause increased liver enzyme levels, especially if it’s taken with a statin drug. Increased liver enzymes can be a sign of liver damage.
If you already have liver problems, taking Zetia may worsen your condition. Talk with your doctor about any liver problems you may have and whether it’s safe for you to take Zetia.
Risk factors for muscle-related problems. Zetia can cause muscle-related side effects. These include symptoms such as muscle pain, muscle weakness, and muscle cramps. If any of the following factors or conditions apply, you may have a higher risk of developing these muscle problems:
- taking other medications, especially high dose statin drugs
- being age 65 years or older
- having hypothyroidism (underactive thyroid)
- having kidney problems
If you have muscle-related side effects during Zetia treatment, talk with your doctor. They may be able to suggest ways to relieve this side effect.
Allergic reaction. If you’ve had an allergic reaction to Zetia or any of its ingredients, you should not take Zetia. Ask your doctor what other medications are better options for you.
Alcohol use and Zetia
Zetia doesn’t interact with alcohol.
But over time, heavy alcohol use can damage your liver. If you develop liver problems, you may be more likely to experience side effects with Zetia. (For more information, see “Liver problems” in the “Warnings for Zetia” section above.)
If you drink alcohol and have questions about drinking it during Zetia treatment, talk with your doctor.
Pregnancy and breastfeeding while taking Zetia
It’s not known if Zetia is safe to take during pregnancy. It’s also not known if the drug is safe to take while breastfeeding or whether the drug passes into breast milk.
If you’re pregnant or breastfeeding, or if you’re planning to become pregnant or breastfeed, tell your doctor. They’ll guide you on the safest treatment options for you.
Zetia’s side effects are usually mild, especially if you’re taking Zetia alone. Taking Zetia with a statin drug may increase your risk of developing some mild or serious side effects. Before starting a new medication, it’s a good idea to talk with a healthcare professional about any questions or concerns you may have.
Here are a few questions to get your discussion started with your doctor:
- Can Zetia cause hair loss?
- Do my other medications increase my risk of side effects with Zetia?
- Would a lower dose of Zetia help to reduce my risk of side effects?
- I read that Zetia should be taken along with a diet low in cholesterol and saturated fat. What foods should I avoid while taking Zetia?
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Q:
Is it harmful to take a coenzyme Q10 (CoQ10) supplement along with Zetia to help prevent muscle-related side effects? Or should I wait to see if I develop such side effects?
Anonymous
A:
If you’re taking Zetia alone, you shouldn’t need to take CoQ10.
Statins, another medication for high cholesterol, are known to cause muscle-related side effects. Sometimes doctors will recommend taking both a statin medication and Zetia for high cholesterol. It’s not clear if CoQ10 prevents muscle-related side effects when Zetia is taken with a statin, but it might help. More research is needed to know for sure.
For most people, CoQ10 isn’t a harmful or dangerous supplement. And taking it with Zetia and a statin likely won’t cause any problems.
Any time you’re considering taking a supplement, it’s important to discuss this with your doctor or pharmacist. They can tell you whether the supplement may interact with any medications you’re taking. You should also look for supplements from reputable manufacturers. Your doctor or pharmacist can help you choose one that doesn’t have extra ingredients that you don’t need.
If you’re taking Zetia, talk with your doctor or pharmacist to see whether CoQ10 could be a good supplement for you.
Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
