Belonging to a class of pharmaceutical compounds called cholesterol absorption inhibitors, Ezetrol is prescribed throughout Europe to help lower the cholesterol levels in those patients which have been unresponsive to lifestyle changes such as healthier diet and regular physical activity. In many cases, it is prescribed to be used in parallel with other major group of medicines used for high cholesterol treatments, namely statins. Available in the form of a tablet, Ezetrol is a branded medicine developed and marketed by Merck Sharp and Dohme (MSD) pharmaceutical company.

What’s on this page?

High cholesterol: What should you know?

Cholesterol is a substance that is presented in numerous dietary elements, but it is mainly produced by the liver. Despite its ‘bad reputation’ cholesterol is actually necessary for the optimal functioning of the cells and bodily functions, but in abnormally high amounts, it won’t be able to be absorbed where it is needed and will instead start to accumulate in the blood vessels, causing them to narrow. Within human body, cholesterol travels through the arteries after the lipids get joined with proteins to form a compound called lipoprotein.

Medical experts differentiate between two types of lipoproteins – high density (HDL) and low density (LDL), colloquially known as good and bad cholesterol. While LDLs play a role in transporting the lipids to the various parts of the organism where they are used by cells that need them, HDL transfer them back to the liver where they get broken down and later excreted – hence the layman’s terms for this compounds.

A high level of LDLs is what causes the condition that is known as high cholesterol. Once this substance starts to accumulate in the arteries, it will narrow them, making it harder for the blood to go through and causing the heart to work harder in order to pump the blood throughout the body efficiently. This is the main mechanism that contributes to the increased risk of heart attack, angina, stroke or other serious cardiovascular conditions and complications.

What causes high cholesterol?

As of now, there is no clear consensus on this issue among the medical experts. While there is general agreement that predisposition for developing high cholesterol play an important role, making this condition at least partly hereditary, it is thought that harmful lifestyle habits and practices play a much more prominent role. Poor diet, lack of exercise, smoking or alcoholism all increase the risk of developing high cholesterol even in people who have no genetic predispositions to this condition. In addition to this, certain underlying medical issues such as diabetes or high blood pressure can also contribute to the onset of high cholesterol.

High cholesterol treatment and management

Once this condition has been diagnosed, the doctor will usually recommend immediate lifestyle changes aimed at:

  • Improving one’s diet
  • Curbing alcohol consumption
  • Eliminating tobacco consumption
  • Improving one’s physical fitness by introducing some light exercise

However, if the condition has progressed enough to pose a risk of further complications, the doctor will recommend using prescription medicines that will help bring cholesterol levels back to normal. Statins (e.g. Pravastatin, Zocor or Simvastatin) are the most commonly prescribed treatment, but in some cases, even they can be largely ineffective. It is in these scenarios that medicines such as Ezetrol are used.

Ezetrol as high cholesterol treatment

The active ingredient of Ezetrol is a cholesterol absorption inhibitor called ezetimibe which works by interfering with the process of absorption of cholesterol from foods in the small intestine. At the same time, it will effectively prevent the cholesterol transferred from the bile duct to the small intestine to be absorbed into the bloodstream. With these multiple mechanisms of action, Ezetrol is very successful in lowering the concentration of LDLs in the blood, thus decreasing the likelihood of arterial blockages or other complications.1

How is Ezetrol used?

At this point, we will try to provide you with just some of the most general things you should keep in mind when using Ezetrol. However, it is important to note that this is not intended to be used as a guide – for a more comprehensive instruction, please refer to the official patient information leaflet that is issued within every pack of the medicine. In addition to this, your prescriber will surely provide you with detailed directions on how to use Ezetrol.

  • Always take as directed
  • Ezetrol should be used only in parallel to cholesterol-lowering diet
  • Typical dose is one tablet daily
  • The tablet can be taken with or without food
  • If you are taking a statin medicine, you can administer both at the same time
  • If you are taking bile acid sequestrants at the same time, make sure to use Ezetrol either two hours before or four hours after that medicine
  • Never exceed the prescribed amount
  • If you miss a dose, do not try to compensate – simply continue with the treatment as usual

Are there any Ezetrol side effects?

Prior to commencing Ezetrol treatment, you should get familiar with side effects – as is the case with all prescription medicines.2 By doing this, you will be able to differentiate between potentially dangerous side effects that might require immediate medical attention and those which might be uncomfortable, but not necessarily dangerous.

However, it is also important to mention that side effects might vary depending on whether you are using Ezetrol on its own or alongside a statin.

When using just Ezetrol

Frequency of occurrence Side effects
Common (1 in 10 users) Stomach pain, diarrhoea, wind or tiredness
Uncommon (1 in 100 users) Abnormal liver or muscle function tests, coughing, indigestion, heartburn, joint pain, muscle spasms, hot flushes, neck pain, loss of appetite, high blood pressure

When used in parallel with a statin

Frequency of occurrence Side effects
Common (1 in 10 users) Abnormal liver function on tests, muscular pain, headaches
Uncommon (1 in 100 users) Tingling, dryness of the mouth, itching, rashes or hives, back pain, swelling of the hands and feet

Keep in mind that this is just a brief overview and not a full list of all known side effects. For a more comprehensive overview, please refer to the official patient information leaflet.

Ezetrol contraindications: Is Ezetrol safe for me?

There are certain scenarios when the use of Ezetrol might be contraindicated by your doctor. Most commonly, this will be the case if you are currently using some of the medicines that have been known to adversely interact with Ezetrol, including:

  • Ciclosporin
  • Anticoagulants
  • Warfarin
  • Phenprocoumon
  • Acenocoumarol
  • Fluindione
  • Fibrates

In addition to this, certain medical conditions might make you unsuitable for Ezetrol treatment. This might be the case if you have:

  • Liver problems
  • Lactose intolerance
  • Allergy to any of the ingredients of the medicine

This medicine is not recommended for women who are trying to conceive and should not be used by those who are already pregnant or are currently breastfeeding.


  1. Ezetimibe therapy: mechanism of action and clinical update – PMC
  2. Ezetimbe – National Library of Medicine