Vytorin (Ezetimibe and Simvastatin) - Oral

What Is Vytorin?

Vytorin is an oral prescription medication containing two different cholesterol-lowering drugs: ezetimibe and simvastatin. Ezetimibe helps lower cholesterol in the blood by reducing how much cholesterol is absorbed from your intestines. Simvastatin is a statin medicine that works by decreasing the amount of cholesterol your body makes.

Drug Facts

Generic Name: Ezetimibe and simvastatin

Brand Name(s): Vytorin

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antihyperlipidemic

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Ezetimibe and simvastatin

Dosage Form(s): Tablet

What Is Vytorin Used For?

The Food and Drug Administration (FDA) approved Vytorin to treat high cholesterol. When combined with diet and exercise, Vytorin can help:

High levels of cholesterol and fat in the blood can cause plaque to build up inside the walls of your arteries (blood vessels that deliver oxygen and nutrients throughout your body). As plaque builds up, the inside of the arteries narrow and may become completely blocked. This can lead to serious health problems, including a heart attack or stroke. Cholesterol-lowering medicines can help decrease your risk of these complications.

Studies have not shown that Vytorin decreases the risk of heart attack or stroke any more than taking simvastatin alone. Talk with your healthcare provider about the benefits of using Vytorin.

Vytorin (Ezetimibe and Simvastatin) Drug Information - Body showing the areas affected

Verywell / Zoe Hansen

How to Take Vytorin

Vytorin should be taken once daily, with or without food in the evening.  Follow a cholesterol-lowering diet and exercise according to your healthcare provider's instructions.

While taking Vytorin, you should avoid grapefruit juice since it can raise levels of simvastatin and increase your chance of developing side effects. Bile acid sequestrants (e.g., cholestyramine, colesevelam, colestipol) can prevent Vytorin from being absorbed. If you take one of these medicines, be sure to take your dose of Vytorin at least two hours before or four hours after taking your bile acid sequestrant.

Storage

Store Vytorin at room temperature in a tightly-closed container. Be sure to keep Vytorin—and all your medicines—in a safe location, up high and out of the reach of children.

How Long Does Vytorin Take to Work?

After starting Vytorin, your healthcare provider may recheck your cholesterol levels as early as four weeks later to see how well the medicine is working.

What Are the Side Effects of Vytorin?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Some people may develop side effects while taking Vytorin. Let your healthcare provider know if you experience any side effects that bother you or don’t go away. Common side effects include:

  • Diarrhea 
  • Headache
  • Increased liver enzymes (indicating possible damage to liver cells) 
  • Muscle pain 
  • Upper respiratory infections

Severe Side Effects

Vytorin can sometimes cause severe and potentially life-threatening reactions. Let your healthcare provider know right away if you develop any severe side effects. Call 911 if your symptoms feel life-threatening or if you think you are having a medical emergency.

Muscle problems (myopathy) and muscle breakdown (rhabdomyolysis), which can rarely lead to kidney failure and death, are potential side effects of Vytorin.

Let your healthcare provider know right away if you develop:

  • Muscle pain
  • Tenderness
  • Weakness, especially if you also have a fever or feel very tired.

Let your healthcare provider know if your muscle pain persists after stopping Vytorin. 

Liver problems, which rarely can lead to death, can occur with Vytorin. Your healthcare provider will check your liver function with a blood test before starting your medication.

Let your healthcare provider know if you develop any signs of liver problems such as:

  • Dark urine 
  • Decreased appetite
  • Feeling very tired or weak 
  • Pain in the upper part of your belly
  • Yellowing of the skin or white parts of your eyes

Report Side Effects

Vytorin may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Vytorin Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high cholesterol:
      • Adults and children 10 to 17 years of age—At first, one tablet with ezetimibe 10 milligrams (mg) plus simvastatin 10 mg or ezetimibe 10 mg plus simvastatin 20 mg once a day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than ezetimibe 10 mg plus simvastatin 40 mg per day.
      • Children younger than 10 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you forget to take your dose of Vytorin, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose, and resume your regular dosing schedule. Don’t double up or take extra Vytorin.

Overdose: What Happens If I Take Too Much Vytorin?

An overdose of Vytorin is not expected to cause serious symptoms, but you may experience vomiting or mucus in your stool. However, consistently taking more than your prescribed dose can cause severe reactions, so be sure to ask your healthcare practitioner or pharmacist if you are unsure how much to take.

What Happens If I Overdose on Vytorin?

If you think you or someone else may have overdosed on Vytorin, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Vytorin, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not use ezetimibe and simvastatin combination if you are also taking boceprevir (Victrelis®), cobicistat-containing products (Stribild®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), danazol (Danocrine®), gemfibrozil (Lopid®), nefazodone (Serzone®), telaprevir (Incivek®), certain antibiotics (eg, clarithromycin, erythromycin, itraconazole, ketoconazole, posaconazole, telithromycin, voriconazole, Nizoral®), or medicines to treat HIV/AIDS (eg, atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, Crixivan®, Kaletra®, Lexiva®, Norvir®, Prezista®, Reyataz®). Using these medicines together with ezetimibe and simvastatin may increase your risk of muscle injury and could result in kidney problems.

Chinese patients who are taking large amounts of niacin (greater than 1 gram or 1000 milligrams per day) together with this medicine may have an increased risk for muscle injury. Talk to your doctor if you are Chinese or have Chinese ancestry and take large amounts of niacin (Niacor®, Niaspan®).

Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness, especially if you also have unusual tiredness or a fever. These may be symptoms of serious muscle problems, such as myopathy or immune-mediated necrotizing myopathy (IMNM). Myopathy is more common when high doses of simvastatin (80 milligrams) with ezetimibe (10 mg) are used, but some people get myopathy with lower doses.

Check with your doctor right away if you have dark-colored urine, diarrhea, a fever, muscle cramps or spasms, muscle pain or stiffness, or feel very tired or weak. These could be symptoms of a serious muscle problem called rhabdomyolysis, which can cause kidney problems.

Call your doctor right away if you get a headache, stomach pain, vomiting, dark-colored urine, loss of appetite, weight loss, general feeling of tiredness or weakness, light-colored stools, upper right stomach pain, or yellow eyes or skin. These could be symptoms of liver damage.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine if you have a major surgery, a major injury, or you develop other serious health problems.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Vytorin?

Certain situations increase your risk of developing complications from Vytorin. Do not take Vytorin if you:

  • Are allergic to ezetimibe, simvastatin, or any other ingredient in Vytorin 
  • Are pregnant, plan to become pregnant, or are breastfeeding 
  • Have active liver disease or high levels of liver enzymes

Some medications should not be taken with Vytorin, such as:

  • Any product containing cobicistat
  • Certain HIV medications 
  • Biaxin or Biaxin XL (clarithromycin)
  • Gengraf, Neoral, and Sandimmune (cyclosporine
  • Danocrine (danazol)
  • Cubicin or Dapzura RT (daptomycin) 
  • Eryc, Eryped, Ery-Tab, and Erythrocin (erythromycin
  • Lopid (gemfibrozil) 
  • Sporanox (itraconazole )
  • Nizoral (ketoconazole)
  • Nefazodone 
  • Noxafil (posaconazole)
  • Red yeast rice supplements 
  • Vfend (voriconazole)

What Other Medications Interact With Vytorin?

Many medications may interact with Vytorin. Be sure to let your healthcare provider and pharmacist know about all the medicines you take, including over-the-counter (OTC) and nonprescription products.

Watch out for these common interactions.

Certain medications should never be taken with Vytorin since they can increase your chance of developing muscle problems, which can sometimes be life-threatening. Do not take Vytorin with:

  • Any product containing cobicistat
  • Certain HIV medications 
  • Clarithromycin 
  • Cyclosporine 
  • Danazol 
  • Daptomycin
  • Erythromycin 
  • Gemfibrozil 
  • Itraconazole 
  • Ketoconazole
  • Nefazodone 
  • Posaconazole
  • Red yeast rice supplements 
  • Voriconazole

Other medications also increase the risk of muscle problems and should be used with caution:

  • Cordarone and Pacerone (amiodarone)
  • Katerzia, Norliqva, Norvasc (amlodipine
  • Colcrys, Gloperba, Mitigare (colchicine
  • Cardizem, Cartia, and others (diltiazem)
  • Multaq (dronedarone)
  • Antara, Fenoglide, Tricor, and others (fenofibrate) 
  • Niacin (doses 1 gram or more)
  • Ranexa (ranolazine)
  • Calan SR, Verelan (verapamil)

Bile acid sequestrants can decrease how much Vytorin is absorbed. Take your dose of Vytorin at least two hours before or four hours after taking your bile acid sequestrant. Bile acid sequestrants include:

Vytorin may increase the blood-thinning effects of warfarin. Your healthcare provider may monitor your INR more frequently.

This is not a complete list of all the drugs that may interact with Vytorin. Always keep an up-to-date list of all the medicines you take and let your healthcare providers know if there are changes.

What Medications Are Similar?

Vytorin is conveniently formulated with two cholesterol-lowering medicines: ezetimibe and simvastatin (a statin medicine). Only one other medication combines ezetimibe with a statin—Roszet (ezetimibe and rosuvastatin).

Other statin medicines include:

This list is a list of drugs also prescribed to lower cholesterol. It is NOT a list of drugs recommended to take with Vytorin. In fact, you should not take these drugs together. Ask your healthcare team if you have any questions about your medications.

Frequently Asked Questions

  • What is Vytorin used for?

    Vytorin is used with diet and exercise to treat high cholesterol. Lowering your cholesterol decreases your risk of certain health conditions, including heart attack and stroke.

  • How does Vytorin work?

    Vytorin contains two different cholesterol-lowering drugs: ezetimibe and simvastatin. These drugs help decrease the amount of cholesterol absorbed by your body and made by your liver.

  • How long does it take for Vytorin to work?

    Vytorin begins to lower cholesterol quickly. Your healthcare provider may order bloodwork as early as four weeks after starting treatment to check for changes in your cholesterol levels.

  • What are the side effects of Vytorin?

    The most common side effects of Vytorin include muscle pain, diarrhea, headache, upper respiratory infections, and increased liver enzymes.

How Can I Stay Healthy While Taking Vytorin?

Diet and exercise are important lifestyle factors that can help lower your cholesterol and improve overall health. But for some people, it’s not enough. Luckily, effective medications, including Vytorin, can help lower your cholesterol and reduce your heart attack and stroke risk.

Before starting Vytorin, review all the warnings and discuss any concerns with your healthcare team. Recognizing the signs of an adverse reaction and knowing when to call your healthcare provider can help keep you healthy while taking Vytorin.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Vytorin label.

  2. American Heart Association. Atherosclerosis.

  3. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation. 2019;139(25):e1082-e1143. doi:10.1161/CIR.0000000000000625

By Christina Varvatsis, PharmD
Christina Varvatsis is a hospital pharmacist and freelance medical writer. She is passionate about helping individuals make informed healthcare choices by understanding the benefits and risks of their treatment options.