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Precautions and Warnings With Ezetimibe/Simvastatin

There are numerous precautions and warnings with ezetimibe/simvastatin to be aware of before starting treatment, including information on who should not use this drug. This medication is not appropriate for pregnant women or people with active liver disease or unexplained high liver enzymes. If you drink alcohol frequently, discuss this with your healthcare provider prior to starting ezetimibe/simvastatin.

Ezetimibe/Simvastatin: What Should I Tell My Healthcare Provider?

Talk to your healthcare provider prior to taking ezetimibe/simvastatin (Vytorin®) if you have:
  • Liver disease or liver failure
  • Kidney disease or kidney failure
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you:
  • Are of Chinese descent
  • Are pregnant or thinking about becoming pregnant
  • Are breastfeeding
  • Will be undergoing a procedure or surgery
  • Drink alcohol frequently.
In addition, tell your healthcare provider about all other medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Ezetimibe/Simvastatin Precautions and Warnings

Some precautions and warnings to be aware of prior to taking ezetimibe/simvastatin include the following:
  • Ezetimibe/simvastatin can interact with certain medications (see Drug Interactions With Ezetimibe/Simvastatin).
  • If you are an alcoholic or drink alcohol frequently, discuss this with your healthcare provider prior to starting ezetimibe/simvastatin. Alcohol can affect the way the liver works, indirectly affecting how ezetimibe/simvastatin works.
  • Statins have been known to cause an increase in liver enzymes. Therefore, it you should have a blood test to check your liver function before starting ezetimibe/simvastatin. These tests may also be recommended if the ezetimibe/simvastatin dosage is changed (see Vytorin and Liver Problems).
Previously it had been recommended that people taking statins have routine periodic liver function tests while taking the medication, but this recommendation has been removed, since such monitoring does not help much to detect or prevent such problems. Liver function tests should still be performed if there is any suspicion of liver damage.
  • Rhabdomyolysis (the severe breakdown of muscles) and other serious muscle problems have been reported rarely with ezetimibe/simvastatin and other statins. Contact your healthcare provider immediately if you experience any muscle pain, weakness, or tenderness, especially if accompanied by body aches or a fever (see Vytorin and Muscle Pain).


  • Studies have suggested that Chinese people may be at a higher risk for serious muscle problems when simvastatin is combined with niacin (see Niacin and Vytorin for more information)


  • Ezetimibe/simvastatin is a pregnancy Category X medicine, which means it could potentially cause harm to your unborn child. The safety of ezetimibe/simvastatin in pregnant women has not been established. Therefore, if you become pregnant while taking this medication, talk to your healthcare provider immediately (see Vytorin and Pregnancy).
  • If you are nursing, it is not known whether ezetimibe/simvastatin passes through breast milk. Therefore, ask your healthcare provider whether to stop nursing or to stop using the medication.
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    Ezetimibe and Simvastatin Drug Information

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