Recent Vytorin Findings

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Recent Vytorin Findings

Question:

What actions, if any, should the general public take based on the recent findings for the drug Vytorin?

Answer:

Vytorin contains two drugs that lower cholesterol — ezetimibe and the statin drug simvastatin. Both drugs are also sold separately. Ezetimibe is sold under the brand name Zetia. Simvastatin is now available as a generic; the brand name is Zocor.

It's well established that people with lower LDL cholesterol levels have less risk of heart attack, stroke and other types of vascular disease. The thinking has been that it didn't matter what you took to lower your LDL cholesterol, as long as you don't also lower the good HDL cholesterol level.

In recent years, the goals for a desirable LDL level have kept getting lower. The LDL goal is less than 70 for those who have known coronary heart disease or are at very high risk of developing it. To reach this goal, it often takes more than just a statin drug.

So ezetimibe seemed liked a perfect partner with a statin. Ezetimibe works in the intestine to block the absorption of cholesterol. Statins lower cholesterol by blocking a certain liver enzyme. Studies showed that ezetimibe and simvastatin together lowered LDL more than just simvastatin or some other statin.

A recent study suggests that adding ezetimibe to a statin such as simvastatin doesn't slow down plaque growth in arteries any more than taking the statin alone.

Until there are studies that show a definite clinical benefit from taking Zetia or Vytorin, I will not be recommending that people start taking either of these medications.

If you are already taking it, you don't need to stop immediately. Zetia and Vytorin are not dangerous. You have time to contact your doctor to discuss your personal situation. Definitely don't stop the Vytorin. It contains simvastatin, a drug with a track record of relative safety and real health benefits.

At a convenient time, you can switch to plain simvastatin. You might need to take a higher dose simvastatin than the amount of simvastatin that is in your current Vytorin prescription.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

Last updated:	July 20, 2009