ezetimibe, simvastatin drug combination profile

Ezetimibe, Simvastatin Drug Combination: A pharmaceutical preparation of ezetimibe and simvastatin that is used in the treatment of HYPERCHOLESTEROLEMIA and HYPERLIPIDEMIAS. [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

ID Source	ID
PubMed CID	9832423
MeSH ID	M0474124

Synonym
vytorin
inegy
ezetimibe-simvastatin combination
ezetimibe, simvastatin drug combination
ezetimibe/simvastatin
ezetimibe and simvastatin
mk 0653a
simvastatin and ezetimibe
butanoic acid, 2,2-dimethyl-, (1s,3r,7s,8s,8ar)-1,2,3,7,8,8a-hexahydro-3,7-dimethyl-8-(2-((2r,4r)-tetrahydro-4-hydroxy-6-oxo-2h-pyran-2-yl)ethyl)-1-naphthalenyl ester, mixt. with (3r,4s)-1-(4-fluorophenyl)-3-((3s)-3-(4-fluorophenyl)-3-hydroxypropyl)-4-(4-
444313-53-5
DTXSID80196177
PNAMDJVUJCJOIX-IUNFJCKHSA-N
[(1s,3r,7s,8s,8ar)-8-[2-[(2r,4r)-4-hydroxy-6-oxooxan-2-yl]ethyl]-3,7-dimethyl-1,2,3,7,8,8a-hexahydronaphthalen-1-yl] 2,2-dimethylbutanoate;(3r,4s)-1-(4-fluorophenyl)-3-[(3s)-3-(4-fluorophenyl)-3-hydroxypropyl]-4-(4-hydroxyphenyl)azetidin-2-one

Research Excerpts

Toxicity

Excerpt	Reference	Relevance
"Despite the excellent benefit/risk profile of statins, their use is limited by a dose-related risk of adverse events, particularly those related to muscle toxicity."	( Striated muscle safety of ezetimibe/simvastatin (Vytorin). Davidson, MH; Maccubbin, D; Musliner, T; Stepanavage, M; Strony, J, 2006)	0.33
" The aim of our study was to evaluate the prevalence of statin-associated adverse events in diabetic and non-diabetic patients affected by polygenic hypercholesterolemia or combined hyperlipidemia and the efficacy and tolerability of treatment with ezetimibe/simvastatin 10/10 mg/day on the same subjects experiencing the adverse events."	( Efficacy and safety of ezetimibe/simvastatin association on non-diabetic and diabetic patients with polygenic hypercholesterolemia or combined hyperlipidemia and previously intolerant to standard statin treatment. Ciccarelli, L; Cicero, AF; D'Angelo, A; Derosa, G; Franzetti, IG; Gadaleta, G; Piccinni, MN; Ragonesi, PD; Scalise, F, 2009)	0.35
" Each Centre used any of the available statins on the basis of current clinical judgement and monitored enrolled patients for adverse events during the following 2 years."	( Efficacy and safety of ezetimibe/simvastatin association on non-diabetic and diabetic patients with polygenic hypercholesterolemia or combined hyperlipidemia and previously intolerant to standard statin treatment. Ciccarelli, L; Cicero, AF; D'Angelo, A; Derosa, G; Franzetti, IG; Gadaleta, G; Piccinni, MN; Ragonesi, PD; Scalise, F, 2009)	0.35
" Patients affected by polygenic hypercholesterolemia experiencing adverse event under statin treatment obtained a significantly lower reduction than those tolerating the treatment (P < 0*001)."	( Efficacy and safety of ezetimibe/simvastatin association on non-diabetic and diabetic patients with polygenic hypercholesterolemia or combined hyperlipidemia and previously intolerant to standard statin treatment. Ciccarelli, L; Cicero, AF; D'Angelo, A; Derosa, G; Franzetti, IG; Gadaleta, G; Piccinni, MN; Ragonesi, PD; Scalise, F, 2009)	0.35
"The efficacy and adverse effect profile of the ezetimibe and simvastatin combination appear to be good for both diabetic and nondiabetic patients, and in both conditions."	( Efficacy and safety of ezetimibe/simvastatin association on non-diabetic and diabetic patients with polygenic hypercholesterolemia or combined hyperlipidemia and previously intolerant to standard statin treatment. Ciccarelli, L; Cicero, AF; D'Angelo, A; Derosa, G; Franzetti, IG; Gadaleta, G; Piccinni, MN; Ragonesi, PD; Scalise, F, 2009)	0.35
"These results showed that both the combined ezetimibe/simvastatin treatment and the simvastatin monotherapy proved to be effective and safe in patients with NAFLD and in cases of high cardiovascular risk."	( Safety and efficacy of combined ezetimibe/simvastatin treatment and simvastatin monotherapy in patients with non-alcoholic fatty liver disease. Abel, T; Dinya, E; Eldin, MG; Fehér, J; Kovács, A, 2009)	0.35
"Combination E/S+N is a safe treatment option for hyperlipidaemic patients including those with DM and MetS, but requires monitoring of glucose and potentially uric acid levels."	( Long-term efficacy and safety of ezetimibe/simvastatin coadministered with extended-release niacin in hyperlipidaemic patients with diabetes or metabolic syndrome. Fazio, S; Guyton, JR; Lin, J; Shah, A; Tershakovec, AM; Tomassini, JE, 2010)	0.36
" Our study enrolled 12 CAPD patients who were experiencing adverse effects from statin therapy."	( Efficacy and safety of ezetimibe and low-dose simvastatin as primary treatment for dyslipidemia in peritoneal dialysis patients. Inoue, T; Kikuta, T; Sato, T; Suzuki, H; Tsuda, M; Watanabe, Y, 2010)	0.36
" Both monotherapy and combination therapy groups had similar incidences of all types of adverse events."	( Retrospective study on antihyperlipidemic efficacy and safety of simvastatin, ezetimibe and their combination in Korean adults. Bae, JW; Choi, CI; Jang, CG; Kim, MJ; Lee, SY; Lee, YH, 2011)	0.37
" Safety was evaluated by monitoring adverse events, laboratory assays, vital signs, physical examinations and 12-lead electrocardiograms."	( Pharmacokinetics and safety of ezetimibe/simvastatin combination tablet: an open-label, single-dose study in healthy Chinese subjects. Chen, WL; Chu, NN; Li, XN; Xu, HR, 2012)	0.38
"To analyze the subsidized use and reported adverse events of ezetimibe, used to lower cholesterol, in Australia over the 11 years following its inclusion on the Pharmaceutical Benefits Scheme (PBS) in 2004."	( Ezetimibe: Use, costs, and adverse events in Australia. David, MC; Hollingworth, SA; Martin, JH; Ostino, R; Tett, SE, 2017)	0.46
" Adverse event data were obtained from the Therapeutic Goods Administration."	( Ezetimibe: Use, costs, and adverse events in Australia. David, MC; Hollingworth, SA; Martin, JH; Ostino, R; Tett, SE, 2017)	0.46
" The major reported adverse events were musculoskeletal and connective tissue disorders and gastrointestinal disorders."	( Ezetimibe: Use, costs, and adverse events in Australia. David, MC; Hollingworth, SA; Martin, JH; Ostino, R; Tett, SE, 2017)	0.46
"Safety end points included adverse events leading to drug discontinuation; adverse muscle, hepatobiliary, and neurocognitive events; and hemorrhagic stroke, heart failure, cancer, and noncardiovascular death."	( Long-term Safety and Efficacy of Achieving Very Low Levels of Low-Density Lipoprotein Cholesterol : A Prespecified Analysis of the IMPROVE-IT Trial. Blazing, MA; Braunwald, E; Cannon, CP; De Ferrari, GM; Giugliano, RP; Murphy, SA; Park, JG; Tershakovec, AM; White, JA; Wiviott, SD, 2017)	0.46

Pharmacokinetics

Excerpt	Reference	Relevance
" The pharmacokinetic parameters for ezetimibe and simvastatin were assessed by determining total ezetimibe, free ezetimibe, simvastatin and simvastatin acid concentrations using a validated liquid chromatography-tandem mass spectrometry method."	( Pharmacokinetics and safety of ezetimibe/simvastatin combination tablet: an open-label, single-dose study in healthy Chinese subjects. Chen, WL; Chu, NN; Li, XN; Xu, HR, 2012)	0.38
"The pharmacokinetic parameters (mean ± SD) for total ezetimibe and free ezetimibe following a single dose were: maximum plasma drug concentration (C(max)) 81."	( Pharmacokinetics and safety of ezetimibe/simvastatin combination tablet: an open-label, single-dose study in healthy Chinese subjects. Chen, WL; Chu, NN; Li, XN; Xu, HR, 2012)	0.38
" Ezetimibe is absorbed in small intestine, reaching peak plasma concentrations in 4-12 h, with a plasma half-life of 22 h."	( Pharmacokinetic drug evaluation of ezetimibe + simvastatin for the treatment of hypercholesterolemia. Bove, M; Cicero, AFG; Fogacci, F, 2017)	0.46

Compound-Compound Interactions

Excerpt	Reference	Relevance
" We investigated the effect of simvastatin monotherapy or its combination with ezetimibe on TLR2 and TLR4 membrane expression and on lipopolysaccharide (LPS)-induced interleukin-1β (IL-1β) and interleukin-6 (IL-6) production in peripheral blood monocytes of patients with primary hypercholesterolemia."	( Effect of simvastatin or its combination with ezetimibe on Toll-like receptor expression and lipopolysaccharide - induced cytokine production in monocytes of hypercholesterolemic patients. Elisaf, MS; Liberopoulos, EN; Milionis, HJ; Moutzouri, E; Rousouli, K; Tellis, CC; Tselepis, AD, 2012)	0.38
" We aimed to investigate the differential association of ezetimibe-statin combination with incident MACE by presence of diabetes."	( Differential association of ezetimibe-simvastatin combination with major adverse cardiovascular events in patients with or without diabetes: a retrospective propensity score-matched cohort study. Cha, BS; Hong, N; Kang, ES; Lee, BW; Lee, CJ; Lee, YH; Park, SH, 2018)	0.48

Bioavailability

Excerpt	Reference	Relevance
"Low aqueous solubility is often a limiting aspect to the bioavailability of poorly soluble, but highly permeable drugs (class II compounds according to the Biopharmaceutics Classification System - BCS) administered in single drug products or as fixed dose combinations."	( New formulation approaches to improve solubility and drug release from fixed dose combinations: case examples pioglitazone/glimepiride and ezetimibe/simvastatin. Dressman, JB; Klein, S; Taupitz, T, 2013)	0.39

Dosage Studied

Excerpt	Relevance	Reference
" By blocking both synthesis and absorption of cholesterol, the fixed combination exerts a cholesterol-lowering effect as important as, or even greater than, that observed with the highest dosage of simvastatin and other statins, with a good tolerance profile."	( [Drug of the month. Ezetimibe/simvastatin tablet (Inegy)]. Radermecker, RP; Scheen, AJ, 2007)	0.34
"5 mg/dl) mainly regardless of previous statin therapy (rosuvastatin, atorvastatin, simvastatin, pravastatin, fluvastatin, and lovastatin) and dosing (pooled median values)."	( [Achievement of blood lipid target levels with Ezetimibe/Simvastatin in patients with atherosclerosis and/or diabetes mellitus--an Austrian observational study]. Slany, J, 2009)	0.35
"Two spectrophotometric methods are presented for the simultaneous determination of ezetimibe/simvastatin and ezetimibe/atorvastatin binary mixtures in combined pharmaceutical dosage forms without prior separation."	( Enhanced spectrophotometric determination of two antihyperlipidemic mixtures containing ezetimibe in pharmaceutical preparations. Barary, MA; El-Kimary, EI; Hassan, EM; Maher, HM; Youssef, RM, 2011)	0.37
" The justifications and benefits of combination therapy are far-reaching, including but not limited to addressing unmet medical needs such as cancer, malaria, and HIV/AIDS, improved clinical efficacy and safety with reduced dosage of a single medication, understanding the underlying science of the disease, alleviating pharmaco-economic impacts, and better drug life-cycle management."	( A case study of single-pill combination therapy: the ezetimibe/simvastatin combination for treatment of hyperlipidemia. Chen, DY; Huang, X, 2012)	0.38
" Dosing was designed to produce comparable low-density lipoprotein cholesterol reductions, while enabling assessment of potential simvastatin-associated pleiotropic effects."	( High-dose simvastatin exhibits enhanced lipid-lowering effects relative to simvastatin/ezetimibe combination therapy. D'Alexandri, FL; Fiehn, O; Grapov, D; Haeggström, JZ; Hyötyläinen, T; Newman, JW; Orešič, M; Pedersen, TL; Pernow, J; Settergren, M; Snowden, SG; Wheelock, CE, 2014)	0.4
" The guideline identifies four cohorts of patients with proven benefits from statin therapy and streamlines the dosing and monitoring recommendations based on evidence from published, randomized controlled trials."	( Implementation of the 2013 American College of Cardiology/American Heart Association Blood Cholesterol Guideline Including Data From the Improved Reduction of Outcomes: Vytorin Efficacy International Trial. Dinkler, J; Watson, K; Ziaeian, B, 2015)	0.42

[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Timeframe	Studies, This Drug (%)	All Drugs %
pre-1990	0 (0.00)	18.7374
1990's	0 (0.00)	18.2507
2000's	42 (28.57)	29.6817
2010's	90 (61.22)	24.3611
2020's	15 (10.20)	2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Publication Type	This drug (%)	All Drugs (%)
Trials	61 (39.87%)	5.53%
Reviews	18 (11.76%)	6.00%
Case Studies	5 (3.27%)	4.05%
Observational	5 (3.27%)	0.25%
Other	64 (41.83%)	84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (28)

Trial Overview

Trial	Phase	Enrollment	Study Type	Start Date	Status
A Multicenter, Randomized, Parallel-Groups, Double-Blind Placebo-Controlled Study Comparing the Efficacy, Safety, and Tolerability of Administration of Ezetimibe/Simvastatin Tablet 10/20 mg Versus Doubling the Dose of Simvastatin 20 mg [Simvastatin 40 mg] [NCT00423579]	Phase 4	120 participants (Actual)	Interventional	2006-07-01	Completed
"A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Factorial Design Study to Evaluate the Lipid-Altering Efficacy and Safety of Ezetimibe/Simvastatin Combination Tablet in Patients With Primary Hypercholesterolemia" [NCT00092651]	Phase 3	1,398 participants (Actual)	Interventional	2002-09-30	Completed
Lipid-lowering Regimes Improve Oxidative Stress, Tryptophan Degradation in Hypercholesterolemia Chronic Kidney Disease Patients [NCT03543774]	Phase 4	30 participants (Anticipated)	Interventional	2018-06-15	Recruiting
A Multicenter, Double-Blind, Randomized Study to Establish the Clinical Benefit and Safety of Vytorin (Ezetimibe/Simvastatin Tablet) vs Simvastatin Monotherapy in High-Risk Subjects Presenting With Acute Coronary Syndrome (IMProved Reduction of Outcomes: [NCT00202878]	Phase 3	18,144 participants (Actual)	Interventional	2005-10-17	Completed
Efficacy of Ezetimibe/Simvastatin 10/20 mg and MK0524A (1-2 g/Day) in Patients With Mixed Hyperlipidemia and Two or More Risk Factors to Cardiovascular Disease. [NCT00738985]	Phase 4	0 participants (Actual)	Interventional	2009-11-30	Withdrawn(stopped due to The study was cancelled due to budget limitations)
Ezetimibe/Simvastatin and Rosuvastatin for Oxidative Stress and Mitochondrial Function in Diabetic Polyneuropathy: a Randomized, Double Blinded, Placebo Controlled Clinical Trial [NCT02129231]	Phase 2	74 participants (Actual)	Interventional	2012-02-29	Completed
Effects of Ezetimibe, Simvastatin, and Vytorin on Reducing L5 in Patients With Metabolic Syndrome [NCT00988364]	Phase 4	30 participants (Actual)	Interventional	2007-03-31	Completed
Additive Effect of Ezetimibe Upon Simvastatin Treatment on Systemic Inflammatory Activity and Endothelial Function During Myocardial Infarction [NCT00905905]	Phase 4	40 participants (Anticipated)	Interventional	2009-05-31	Completed
Post - Marketing Surveillance of the Safety, Tolerability and Efficacy of Vytorin (Ezetimibe + Simvastatin) Tablet Among Filipino Patients [NCT00909389]		4,748 participants (Actual)	Observational	2006-11-30	Completed
Efficacy and Safety of Simvastatin-ezetimibe Combination Therapy in Reduction of Progression of Atherosclerosis Among Patients With Systemic Lupus Erythematosus: A Randomized Single-Blind Trial [NCT02548936]	Early Phase 1	30 participants (Actual)	Interventional	2015-04-30	Enrolling by invitation
Comparative Efficacy of a Vytorin 10/80 Tablet Split Into 4 (Estimated Dose Ezetimibe 2.5 + Simvastatin 20) Versus Simvastatin 20 Milligrams on LDL Cholesterol [NCT00762164]	Phase 4	34 participants (Actual)	Interventional	2007-03-31	Completed
To Study the Effect of Vytorin on Intracellular Lipid and Inflammation in Obese Subjects [NCT01420328]	Phase 3	20 participants (Anticipated)	Interventional	2011-05-31	Active, not recruiting
SCH 465981: Assessment of Bi-Directional Interaction Between Components of Vytorin® (Ezetimibe and Simvastatin) and Niaspan® (Niacin Extended-Release Tablets) in Healthy Subjects [NCT00652431]	Phase 1	18 participants (Actual)	Interventional	2007-05-31	Completed
Effects on Atherosclerosis Regression of Ezetimibe Monotherapy or Ezetimibe Plus Simvastatin Combination Therapy: Evaluation by Fluorodeoxyglucose Positron Emission Tomography [NCT00926055]		0 participants (Actual)	Interventional	2011-09-30	Withdrawn
An Open-label Exploratory Study of the Pharmacokinetic Interaction of CXA-10 Administered to Steady State With Pravastatin and Vytorin® (Simvastatin and Ezetimibe) in Healthy Males [NCT02547402]	Phase 1	10 participants (Actual)	Interventional	2015-12-31	Completed
A Randomized Trial of the Long-term Clinical Effects of Raising HDL Cholesterol With Extended Release Niacin/Laropiprant [NCT00461630]	Phase 3	25,673 participants (Actual)	Interventional	2007-01-31	Completed
Rho-kinase in Patients With Atherosclerosis: Effects of Statins A Randomized Clinical Trial Comparing Ezetimibe/Simvastatin and Simvastatin [NCT00560170]	Phase 4	40 participants (Actual)	Interventional	2007-09-30	Completed
Clinical Trial of Zocor and Vytorin in Adolescents With Type 1 Diabetes [NCT00477204]	Phase 2	9 participants (Actual)	Interventional	2007-05-31	Completed
A Pilot Study To Evaluate the Efficacy of Vytorin (Simvastatin +Ezetimibe) In the Treatment of Alopecia Areata [NCT01520077]	Phase 1	29 participants (Actual)	Interventional	2011-07-31	Completed
The Effects of Ezetimibe on Postprandial Hyperlipidemia and Endothelial Dysfunction in Patients With the Metabolic Syndrome. [NCT00189085]	Phase 4	20 participants	Interventional	2004-12-31	Completed
A Multicenter, Open-label, 6 Week Study to Evaluate the Efficacy and Safety of Algorithm Based Intensive Treatment With Vytorin Versus Standard Treatment of Other Statins in Moderate, Moderately High and High Risk Patients. [NCT01587235]	Phase 4	0 participants (Actual)	Interventional	2013-03-31	Withdrawn
The Effects of Ezetimibe/Simvastatin Versus Simvastatin Alone on Platelet and Inflammatory Biomarkers in Patients With the Metabolic Syndrome [NCT00819403]	Phase 4	15 participants (Actual)	Interventional	2009-01-31	Completed
Phase 3, Open-Label, Multi-Center, Double-Blind, Randomized, Parallel Group Study Efficacy and Safety of Fixed Combination Torcetrapib/Atorvastatin, Administered Once Daily (QD) Compared to Fixed Combination Ezetimibe/Simvastatin for 6 Weeks in Subjects W [NCT00267267]	Phase 3	1,784 participants	Interventional	2006-01-31	Terminated
[NCT01660945]	Phase 4	204 participants (Actual)	Interventional	2011-07-31	Completed
[NCT01666067]	Phase 4	204 participants (Actual)	Interventional	2011-11-30	Completed
A Randomized, Double-Blind, Active-Controlled Study of Patients With Primary Hypercholesterolemia and High Cardiovascular Risk and Not Adequately Controlled With Atorvastatin: A Comparison of Switching to a Combination Tablet Ezetimibe/Simvastatin Versus [NCT00782184]	Phase 3	250 participants (Actual)	Interventional	2008-11-30	Completed
Multicenter, Randomized, Double-Blind Study to Evaluate the Efficacy and Safety of Ezetimibe/Simvastatin and Niacin (Extended Release Tablet) Co-Administered in Patients With Type IIa or Type IIb Hyperlipidemia [NCT00271817]	Phase 3	1,220 participants (Actual)	Interventional	2005-12-31	Completed
Study of Lipoprotein Subfractions, Inflammation, Oxidative Stress and Endothelial Function After Treatment With Simvastatin and Ezetimibe Administered Alone and in Combination in Hyperlipidemic Patients [NCT02304926]		42 participants (Actual)	Interventional	2009-01-31	Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

Trial	Outcome
NCT00202878 (4) [back to overview]	Time to First Occurrence of Cardiovascular Death, Major Coronary Event, or Non-fatal Stroke (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)
NCT00202878 (4) [back to overview]	Time to First Occurrence of Coronary Heart Disease (CHD) Death, Non-fatal MI, or Urgent Coronary Revascularization With PCI or CABG ≥ 30 Days After Randomization (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)
NCT00202878 (4) [back to overview]	Time to First Occurrence of CV Death, Nonfatal MI, UA With Hospitalization, All Revascularization Occurring ≥30 Days After Randomization, and Non-fatal Stroke (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)
NCT00202878 (4) [back to overview]	Time to First Occurrence of Death From Any Cause, Major Coronary Event, or Non-fatal Stroke (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in Low-Density Lipoprotein-Cholesterol (LDL-C)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in Low-Density Lipoprotein-Cholesterol (LDL-C)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in Low-Density Lipoprotein-Cholesterol (LDL-C)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in High-Density Lipoprotein-Cholesterol (HDL-C)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in High-Density Lipoprotein-Cholesterol (HDL-C)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in Non-High-Density Lipoprotein-Cholesterol (Non-HDL-C)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in Non-High-Density Lipoprotein-Cholesterol (Non-HDL-C)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in Non-High-Density Lipoprotein-Cholesterol (Non-HDL-C)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in Triglycerides (TG)
NCT00271817 (10) [back to overview]	Percent Change From Baseline in Triglycerides (TG)
NCT00423579 (1) [back to overview]	Change in Low-density-lipoprotein Cholesterol (LDL-C) at 6 Weeks
NCT00461630 (5) [back to overview]	Stroke
NCT00461630 (5) [back to overview]	Coronary or Non-coronary Revascularisation
NCT00461630 (5) [back to overview]	Major Coronary Events
NCT00461630 (5) [back to overview]	Major Vascular Event
NCT00461630 (5) [back to overview]	Mortality
NCT00477204 (1) [back to overview]	Change in LDL-c From Baseline to 6 Months in Subjects With Type 1 Diabetes Taking Vytorin or Zocor.
NCT00762164 (2) [back to overview]	LDL Cholesterol
NCT00762164 (2) [back to overview]	Total Cholesterol
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Apolipoprotein B
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Apolipoprotein B/A-1 Ratio
NCT00782184 (15) [back to overview]	Percent Change From Baseline in High-sensitivity C-Reactive Protein (Hs-CRP)
NCT00782184 (15) [back to overview]	Percent Change From Baseline in LDL-Cholesterol/HDL-Cholesterol Ratio
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Low Density Lipoprotein (LDL)-C
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Non-HDL Cholesterol
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Non-HDL Cholesterol/HDL-Cholesterol Ratio
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Total Cholesterol
NCT00782184 (15) [back to overview]	Percent Change From Baseline in High-Density Lipoprotein (HDL) Cholesterol
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Triglycerides
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Total Cholesterol/HDL-Cholesterol Ratio
NCT00782184 (15) [back to overview]	Number of Participants Reaching LDL-C Target Goal <100 mg/dL
NCT00782184 (15) [back to overview]	Number of Participants Reaching LDL-C Target Goal <77 mg/dL
NCT00782184 (15) [back to overview]	Number of Participants Reaching LDL-C Target Goals of <70 mg/dL
NCT00782184 (15) [back to overview]	Percent Change From Baseline in Apolipoprotein A-1
NCT00819403 (2) [back to overview]	Ex Vivo Effects of Treatment With Vytorin Versus Zocor for 6 Weeks on Platelet Alpha Thrombin PAR-1 Receptor Expression
NCT00819403 (2) [back to overview]	Biomarkers of Inflammation
NCT00909389 (1) [back to overview]	Number of Participants Who Had an Adverse Event (AE).
NCT00988364 (2) [back to overview]	L5 Concentration in Metabolic Syndrome Patients
NCT00988364 (2) [back to overview]	L5 Concentration After Treatment of Ezetimibe, Simvastatin, or Vytorin in Metabolic Syndrome Patients
NCT02304926 (20) [back to overview]	Apolipoprotein B Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	High-density Lipoprotein Cholesterol (HDLc) Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Leukocyte Adhesion Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Leukocyte Rolling Flux Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Leukocyte Rolling Velocity Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Levels of E-selectin Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Levels of Glutathione (GSH) Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Levels of High-sensitive C-reactive Protein (hsCRP) Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Levels of Intercellular Adhesion Molecule 1 (ICAM-1) Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Levels of Interleukin-6 (IL-6) Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Levels of Tumor Necrosis Factor α (TNF-α) Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Levels of Vascular Cell Adhesion Molecule 1 (VCAM-1) Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Low Density Lipoprotein Size Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Low-density Lipoprotein Cholesterol (LDLc) Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Membrane Potential Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Mitochondrial Oxygen (O2) Consumption Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Non-HDL Cholesterol Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Reactive Oxygen Species (ROS) Production Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Total Cholesterol Before and After Simvastatin/Ezetimibe Administration
NCT02304926 (20) [back to overview]	Triglycerides Before and After Simvastatin/Ezetimibe Administration

Time to First Occurrence of Cardiovascular Death, Major Coronary Event, or Non-fatal Stroke (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)

The time (in months) from study start to the first occurrence of any of the following clinical outcomes was recorded: cardiovascular death, major coronary Event (non-fatal myocardial infarction [MI], documented unstable angina [UA] requiring hospitalization, or coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) ≥ 30 days after randomization), or non-fatal Stroke. A Clinical Endpoints Committee (CEC) reviewed and adjudicated each suspected efficacy endpoint event while blinded to treatment. Participants who did not have any endpoint event until last visit or who were lost to follow-up and had no event were censored at the time of last available information (last study visit). The Kaplan-Meier estimate reports the percentage of participants who experienced cardiovascular death, major coronary event, or non-fatal stroke within 7 years from randomization. (NCT00202878)
Timeframe: Up to approximately 9 years

Intervention	Percentage of Participants (Number)
Ezetimibe/Simvastatin	32.72
Simvastatin	34.67

Intervention	Percent change (Mean)
Ezetimibe/Simvastatin	-49.3
Ezetimibe/Simvastatin + Niacin	-54.0

Intervention	Percent change (Mean)
Ezetimibe/Simvastatin	-53.5
Ezetimibe/Simvastatin + Niacin	-58.5

Intervention	Percent change (Mean)
Ezetimibe/Simvastatin	-47.9
Ezetimibe/Simvastatin + Niacin	-55.6

Intervention	Percent change (Mean)
Ezetimibe/Simvastatin	-45.1
Ezetimibe/Simvastatin + Niacin	-52.4

Intervention	Percent change (Median)
Ezetimibe/Simvastatin	23.7
Ezetimibe/Simvastatin + Niacin	-42.5

Intervention	Percent change (Median)
Ezetimibe/Simvastatin	-26.8
Ezetimibe/Simvastatin + Niacin	-44.5

Intervention	percentage change (Mean)
Ezetimibe/Simvastatin 10/20 mg + Simvastatin Placebo	-26.5
Ezetimibe/Simvastatin Placebo + Simvastatin 40 mg	-11.9

Intervention	ng/dl (Mean)
	PAR 1/4 antigen	PAR 1/4 activity
Simvastatin	35.4	23.6
Simvastatin/Ezetimibe	34.5	22.5

Intervention	polymorphonuclear cells/mm2 (Mean)
	Baseline	4 weeks	8 weeks
Ezetimibe	25.6	23.8	12.5
Simvastatin	25.1	15.0	10.9

Substance	Relationship Strength	Studies	Trials	Classes	Roles
allantoin [no description available]	5.37	2	2	imidazolidine-2,4-dione; ureas	Escherichia coli metabolite; human metabolite; Saccharomyces cerevisiae metabolite; vulnerary
niacin Niacin: A water-soluble vitamin of the B complex occurring in various animal and plant tissues. It is required by the body for the formation of coenzymes NAD and NADP. It has PELLAGRA-curative, vasodilating, and antilipemic properties.. vitamin B3 : Any member of a group of vitamers that belong to the chemical structural class called pyridines that exhibit biological activity against vitamin B3 deficiency. Vitamin B3 deficiency causes a condition known as pellagra whose symptoms include depression, dermatitis and diarrhea. The vitamers include nicotinic acid and nicotinamide (and their ionized and salt forms).. nicotinic acid : A pyridinemonocarboxylic acid that is pyridine in which the hydrogen at position 3 is replaced by a carboxy group.	6.95	4	4	pyridine alkaloid; pyridinemonocarboxylic acid; vitamin B3	antidote; antilipemic drug; EC 3.5.1.19 (nicotinamidase) inhibitor; Escherichia coli metabolite; human urinary metabolite; metabolite; mouse metabolite; plant metabolite; vasodilator agent
uric acid Uric Acid: An oxidation product, via XANTHINE OXIDASE, of oxypurines such as XANTHINE and HYPOXANTHINE. It is the final oxidation product of purine catabolism in humans and primates, whereas in most other mammals URATE OXIDASE further oxidizes it to ALLANTOIN.. uric acid : An oxopurine that is the final oxidation product of purine metabolism.. 6-hydroxy-1H-purine-2,8(7H,9H)-dione : A tautomer of uric acid having oxo groups at C-2 and C-8 and a hydroxy group at C-6.. 7,9-dihydro-1H-purine-2,6,8(3H)-trione : An oxopurine in which the purine ring is substituted by oxo groups at positions 2, 6, and 8.	5.37	2	2	uric acid	Escherichia coli metabolite; human metabolite; mouse metabolite
fenofibrate Pharmavit: a polyvitamin product, comprising vitamins A, D2, B1, B2, B6, C, E, nicotinamide, & calcium pantothene; may be a promising agent for application to human populations exposed to carcinogenic and genetic hazards of ionizing radiation; RN from CHEMLINE	4.34	1	1	aromatic ether; chlorobenzophenone; isopropyl ester; monochlorobenzenes	antilipemic drug; environmental contaminant; geroprotector; xenobiotic
glimepiride glimepiride: structure given in first source	2.08	1	0	sulfonamide
minoxidil Minoxidil: A potent direct-acting peripheral vasodilator (VASODILATOR AGENTS) that reduces peripheral resistance and produces a fall in BLOOD PRESSURE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p371). minoxidil : A pyrimidine N-oxide that is pyrimidine-2,4-diamine 3-oxide substituted by a piperidin-1-yl group at position 6.	2.25	1	0	dialkylarylamine; tertiary amino compound
pioglitazone Pioglitazone: A thiazolidinedione and PPAR GAMMA agonist that is used in the treatment of TYPE 2 DIABETES MELLITUS.. pioglitazone : A member of the class of thiazolidenediones that is 1,3-thiazolidine-2,4-dione substituted by a benzyl group at position 5 which in turn is substituted by a 2-(5-ethylpyridin-2-yl)ethoxy group at position 4 of the phenyl ring. It exhibits hypoglycemic activity.	2.08	1	0	aromatic ether; pyridines; thiazolidinediones	antidepressant; cardioprotective agent; EC 2.7.1.33 (pantothenate kinase) inhibitor; EC 6.2.1.3 (long-chain-fatty-acid--CoA ligase) inhibitor; ferroptosis inhibitor; geroprotector; hypoglycemic agent; insulin-sensitizing drug; PPARgamma agonist; xenobiotic
prednisolone Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states.. prednisolone : A glucocorticoid that is prednisone in which the oxo group at position 11 has been reduced to the corresponding beta-hydroxy group. It is a drug metabolite of prednisone.	2.25	1	0	11beta-hydroxy steroid; 17alpha-hydroxy steroid; 20-oxo steroid; 21-hydroxy steroid; 3-oxo-Delta(1),Delta(4)-steroid; C21-steroid; glucocorticoid; primary alpha-hydroxy ketone; tertiary alpha-hydroxy ketone	adrenergic agent; anti-inflammatory drug; antineoplastic agent; drug metabolite; environmental contaminant; immunosuppressive agent; xenobiotic
pyrroles 1H-pyrrole : A tautomer of pyrrole that has the double bonds at positions 2 and 4.. pyrrole : A five-membered monocyclic heteroarene comprising one NH and four CH units which forms the parent compound of the pyrrole group of compounds. Its five-membered ring structure has three tautomers. A 'closed class'.. azole : Any monocyclic heteroarene consisting of a five-membered ring containing nitrogen. Azoles can also contain one or more other non-carbon atoms, such as nitrogen, sulfur or oxygen.	11.4	14	7	pyrrole; secondary amine
fluorobenzenes Fluorobenzenes: Derivatives of BENZENE that contain FLUORINE.. monofluorobenzene : The simplest member of the class of monofluorobenzenes that is benzene carrying a single fluoro substituent.. fluorobenzenes : Any fluoroarene that is a benzene or a substituted benzene carrying at least one fluoro group.	8.92	10	8	monofluorobenzenes	NMR chemical shift reference compound
homocystine [no description available]	3.46	1	1	amino acid zwitterion; homocystines	human metabolite
malondialdehyde Malondialdehyde: The dialdehyde of malonic acid.. malonaldehyde : A dialdehyde that is propane substituted by two oxo groups at the terminal carbon atoms respectively. A biomarker of oxidative damage to lipids caused by smoking, it exists in vivo mainly in the enol form.	5.37	2	2	dialdehyde	biomarker
triamcinolone Triamcinolone: A glucocorticoid given, as the free alcohol or in esterified form, orally, intramuscularly, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. (From Martindale, The Extra Pharmacopoeia, 30th ed, p739). triamcinolone : A C21-steroid hormone that is 1,4-pregnadiene-3,20-dione carrying four hydroxy substituents at positions 11beta, 16alpha, 17alpha and 21 as well as a fluoro substituent at position 9. Used in the form of its 16,17-acetonide to treat various skin infections.	2.25	1	0	11beta-hydroxy steroid; 16alpha-hydroxy steroid; 17alpha-hydroxy steroid; 20-oxo steroid; 21-hydroxy steroid; 3-oxo-Delta(4) steroid; C21-steroid hormone; fluorinated steroid; glucocorticoid; primary alpha-hydroxy ketone; tertiary alpha-hydroxy ketone	anti-allergic agent; anti-inflammatory drug
simvastatin Simvastatin: A derivative of LOVASTATIN and potent competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HYDROXYMETHYLGLUTARYL COA REDUCTASES), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL RECEPTORS, it increases breakdown of LDL CHOLESTEROL.. simvastatin : A member of the class of hexahydronaphthalenes that is lovastatin in which the 2-methylbutyrate ester moiety has been replaced by a 2,2-dimethylbutyrate ester group. It is used as a cholesterol-lowering and anti-cardiovascular disease drug.	18.19	111	47	delta-lactone; fatty acid ester; hexahydronaphthalenes; statin (semi-synthetic)	EC 1.1.1.34/EC 1.1.1.88 (hydroxymethylglutaryl-CoA reductase) inhibitor; EC 3.4.24.83 (anthrax lethal factor endopeptidase) inhibitor; ferroptosis inducer; geroprotector; prodrug
pravastatin Pravastatin: An antilipemic fungal metabolite isolated from cultures of Nocardia autotrophica. It acts as a competitive inhibitor of HMG CoA reductase (HYDROXYMETHYLGLUTARYL COA REDUCTASES).. pravastatin : A carboxylic ester resulting from the formal condensation of (S)-2-methylbutyric acid with the hydroxy group adjacent to the ring junction of (3R,5R)-7-[(1S,2S,6S,8S,8aR)-6,8-dihydroxy-2-methyl-1,2,6,7,8,8a-hexahydronaphthalen-1-yl]-3,5-dihydroxyheptanoic acid. Derived from microbial transformation of mevastatin, pravastatin is a reversible inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA). The sodium salt is used for lowering cholesterol and preventing cardiovascular disease. It is one of the lower potency statins, but has the advantage of fewer side effects compared with lovastatin and simvastatin.	3.51	1	1	3-hydroxy carboxylic acid; carbobicyclic compound; carboxylic ester; hydroxy monocarboxylic acid; secondary alcohol; statin (semi-synthetic)	anticholesteremic drug; environmental contaminant; metabolite; xenobiotic
atorvastatin [no description available]	11.6	15	8	aromatic amide; dihydroxy monocarboxylic acid; monofluorobenzenes; pyrroles; statin (synthetic)	environmental contaminant; xenobiotic
5-methylcytosine 5-Methylcytosine: A methylated nucleotide base found in eukaryotic DNA. In ANIMALS, the DNA METHYLATION of CYTOSINE to form 5-methylcytosine is found primarily in the palindromic sequence CpG. In PLANTS, the methylated sequence is CpNpGp, where N can be any base.. 5-methylcytosine : A pyrimidine that is a derivative of cytosine, having a methyl group at the 5-position.	4.45	1	1	methylcytosine; pyrimidines	human metabolite
lathosterol lathosterol: RN given refers to (3beta,5alpha)-isomer. 5alpha-cholest-7-en-3beta-ol : A cholestanoid that is (5alpha)-cholest-7-ene substituted by a beta-hydroxy group at position 3.	3.41	1	1	3beta-sterol; C27-steroid; cholestanoid; Delta(7)-sterol	human metabolite; mouse metabolite
fibrinogen Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three non-identical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products.. D-iditol : The D-enantiomer of iditol.	3.44	1	1	iditol	fungal metabolite
methotrexate [no description available]	2.21	1	0	dicarboxylic acid; monocarboxylic acid amide; pteridines	abortifacient; antimetabolite; antineoplastic agent; antirheumatic drug; dermatologic drug; DNA synthesis inhibitor; EC 1.5.1.3 (dihydrofolate reductase) inhibitor; immunosuppressive agent
ezetimibe Ezetimibe: An azetidine derivative and ANTICHOLESTEREMIC AGENT that inhibits intestinal STEROL absorption. It is used to reduce total CHOLESTEROL; LDL CHOLESTEROL, and APOLIPOPROTEINS B in the treatment of HYPERLIPIDEMIAS.. ezetimibe : A beta-lactam that is azetidin-2-one which is substituted at 1, 3, and 4 by p-fluorophenyl, 3-(p-fluorophenyl)-3-hydroxypropyl, and 4-hydroxyphenyl groups, respectively (the 3R,3'S,4S enantiomer).	12.05	34	9	azetidines; beta-lactam; organofluorine compound	anticholesteremic drug; antilipemic drug; antimetabolite
coenzyme q10 coenzyme Q10: Ubiquinone ring with a chain of 10 isoprene units; redox equilibrium with ubiqunol serving in mitochondrial inner membrane to transfer electrons; presence during reconstitution of acetylcholine receptor into phospholipid vesicles yields vesicles active in catalyzing carbamylcholine-sensitive Na+ flux; coenzyme Q10 depletion has been noted with use of statins. coenzyme Q10 : A ubiquinone having a side chain of 10 isoprenoid units. In the naturally occurring isomer, all isoprenyl double bonds are in the E- configuration.	3.41	1	1	ubiquinones	antioxidant; ferroptosis inhibitor; human metabolite
25-hydroxyvitamin d 2 25-Hydroxyvitamin D 2: 9,10-Secoergosta-5,7,10(19),22-tetraene-3,25-diol. Biologically active metabolite of vitamin D2 which is more active in curing rickets than its parent. The compound is believed to attach to the same receptor as vitamin D2 and 25-hydroxyvitamin D3.	3.47	1	1	hydroxycalciol; seco-ergostane; vitamin D	bone density conservation agent; human xenobiotic metabolite; nutraceutical
cholestanol Cholestanol: A cholesterol derivative found in human feces, gallstones, eggs, and other biological matter.	3.41	1	1	cholestanoid
mocetinostat mocetinostat: undergoing phase II clinical trials for treatment of cancer. mocetinostat : A benzamide obtained by formal condensation of the carboxy group of 4-({[4-(pyridin-3-yl)pyrimidin-2-yl]amino}methyl)benzoic acid with one of the amino groups of benzene-1,2-diamine. It is an orally active and isotype-selective HDAC inhibitor which exhibits antitumour activity (IC50 = 0.15, 0.29, 1.66 and 0.59 muM for HDAC1, HDAC2, HDAC3 and HDAC11).	2.05	1	0	aminopyrimidine; benzamides; pyridines; secondary amino compound; secondary carboxamide; substituted aniline	antineoplastic agent; apoptosis inducer; autophagy inducer; cardioprotective agent; EC 3.5.1.98 (histone deacetylase) inhibitor; hepatotoxic agent
phytosterols Phytosterols: A class of organic compounds known as sterols or STEROIDS derived from plants.. phytosterols : Sterols similar to cholesterol which occur in plants and vary only in carbon side chains and/or presence or absence of a double bond.	3.5	1	1
phosphatidylcholines Phosphatidylcholines: Derivatives of PHOSPHATIDIC ACIDS in which the phosphoric acid is bound in ester linkage to a CHOLINE moiety.	3.48	1	1	1,2-diacyl-sn-glycero-3-phosphocholine
ubiquinone Ubiquinone: A lipid-soluble benzoquinone which is involved in ELECTRON TRANSPORT in mitochondrial preparations. The compound occurs in the majority of aerobic organisms, from bacteria to higher plants and animals.	3.41	1	1
glycolipids [no description available]	3.48	1	1
natriuretic peptide, brain Natriuretic Peptide, Brain: A PEPTIDE that is secreted by the BRAIN and the HEART ATRIA, stored mainly in cardiac ventricular MYOCARDIUM. It can cause NATRIURESIS; DIURESIS; VASODILATION; and inhibits secretion of RENIN and ALDOSTERONE. It improves heart function. It contains 32 AMINO ACIDS.	3.7	1	1	polypeptide

Intervention	mg/dl (Mean)
Vytorin (Ezetimibe/Simvastatin)	-67
Zocor (Simvastatin)	-6

Intervention	percent change from baseline (Least Squares Mean)
Ezetimibe/Simvastatin 10/40	-17.23
Atorvastatin 40 mg	-9.53

Intervention	percent change from baseline (Least Squares Mean)
Ezetimibe/Simvastatin 10/40	-18.59
Atorvastatin 40 mg	-5.67

Intervention	percent change from baseline (Least Squares Mean)
Ezetimibe/Simvastatin 10/40	-6.18
Atorvastatin 40 mg	-8.86

Condition	Relationship Strength	Studies	Trials
Cardiac Failure [description not available]	4.72	1	1
Cardiovascular Stroke [description not available]	8.36	9	6
Cardiac Arrest, Sudden [description not available]	4.72	1	1
Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.	4.72	1	1
Myocardial Infarction NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).	8.36	9	6
Death, Sudden, Cardiac Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005)	4.72	1	1
Acute Coronary Syndrome An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.	12.57	27	12
Alopecia Cicatrisata [description not available]	2.25	1	0
Alopecia Absence of hair from areas where it is normally present.	2.25	1	0
Dyslipidemia [description not available]	10.78	15	6
Chronic Kidney Diseases [description not available]	7	5	2
Cardiovascular Diseases Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.	11.32	18	7
Dyslipidemias Abnormalities in the serum levels of LIPIDS, including overproduction or deficiency. Abnormal serum lipid profiles may include high total CHOLESTEROL, high TRIGLYCERIDES, low HIGH DENSITY LIPOPROTEIN CHOLESTEROL, and elevated LOW DENSITY LIPOPROTEIN CHOLESTEROL.	10.78	15	6
Renal Insufficiency, Chronic Conditions in which the KIDNEYS perform below the normal level for more than three months. Chronic kidney insufficiency is classified by five stages according to the decline in GLOMERULAR FILTRATION RATE and the degree of kidney damage (as measured by the level of PROTEINURIA). The most severe form is the end-stage renal disease (CHRONIC KIDNEY FAILURE). (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002)	7	5	2
Muscle Disorders [description not available]	6.13	3	2
Muscular Diseases Acquired, familial, and congenital disorders of SKELETAL MUSCLE and SMOOTH MUSCLE.	6.13	3	2
Infections, Coronavirus [description not available]	2.25	1	0
2019 Novel Coronavirus Disease [description not available]	2.25	1	0
Pneumonia, Viral Inflammation of the lung parenchyma that is caused by a viral infection.	2.25	1	0
Coronavirus Infections Virus diseases caused by the CORONAVIRUS genus. Some specifics include transmissible enteritis of turkeys (ENTERITIS, TRANSMISSIBLE, OF TURKEYS); FELINE INFECTIOUS PERITONITIS; and transmissible gastroenteritis of swine (GASTROENTERITIS, TRANSMISSIBLE, OF SWINE).	2.25	1	0
Disease Models, Animal Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases.	2.25	1	0
Infective Endocarditis [description not available]	2.25	1	0
Heart Valve Diseases Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE).	2.25	1	0
Elevated Cholesterol [description not available]	15.64	49	19
Sclerosis A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve.	2.25	1	0
Endocarditis Inflammation of the inner lining of the heart (ENDOCARDIUM), the continuous membrane lining the four chambers and HEART VALVES. It is often caused by microorganisms including bacteria, viruses, fungi, and rickettsiae. Left untreated, endocarditis can damage heart valves and become life-threatening.	2.25	1	0
Hypercholesterolemia A condition with abnormally high levels of CHOLESTEROL in the blood. It is defined as a cholesterol value exceeding the 95th percentile for the population.	15.64	49	19
Aortic Stenosis [description not available]	7.95	6	3
Aortic Valve Stenosis A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.	7.95	6	3
Hypernatremia Excessive amount of sodium in the blood. (Dorland, 27th ed)	3.7	1	1
Hyponatremia Deficiency of sodium in the blood; salt depletion. (Dorland, 27th ed)	3.7	1	1
Atheroma [description not available]	3.98	2	1
Arterial Diseases, Carotid [description not available]	4.38	4	1
Innate Inflammatory Response [description not available]	5.93	4	2
Carotid Artery Diseases Pathological conditions involving the CAROTID ARTERIES, including the common, internal, and external carotid arteries. ATHEROSCLEROSIS and TRAUMA are relatively frequent causes of carotid artery pathology.	4.38	4	1
Inflammation A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function.	5.93	4	2
Diathesis [description not available]	2.31	1	0
Atherogenesis [description not available]	6.66	6	2
Diabetes Mellitus, Adult-Onset [description not available]	10.54	15	9
Diabetes Mellitus, Type 2 A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY.	10.54	15	9
Atherosclerosis A thickening and loss of elasticity of the walls of ARTERIES that occurs with formation of ATHEROSCLEROTIC PLAQUES within the ARTERIAL INTIMA.	6.66	6	2
Angina at Rest [description not available]	5.99	3	3
Complication, Postoperative [description not available]	3.53	1	1
Angina, Unstable Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.	5.99	3	3
Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	3.53	1	1
Hyperlipemia [description not available]	9.68	8	5
Hyperlipidemias Conditions with excess LIPIDS in the blood.	9.68	8	5
Obesity A status with BODY WEIGHT that is grossly above the recommended standards, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).	4.45	1	1
Diabetes Mellitus A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.	8.32	9	3
Apoplexy [description not available]	5.85	7	1
Stroke A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)	5.85	7	1
Biliary Calculi [description not available]	3.56	1	1
Gallstones Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER, resulting in the condition of CHOLELITHIASIS. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, or bilirubin.	3.56	1	1
Alopecia Circumscripta [description not available]	2.21	1	0
Alopecia Areata Loss of scalp and body hair involving microscopically inflammatory patchy areas.	2.21	1	0
Neointima The new and thickened layer of scar tissue that forms on a PROSTHESIS, or as a result of vessel injury especially following ANGIOPLASTY or stent placement.	2.08	1	0
Cardiometabolic Syndrome A cluster of symptoms that are risk factors for CARDIOVASCULAR DISEASES and TYPE 2 DIABETES MELLITUS. The major components not only include metabolic dysfunctions of METABOLIC SYNDROME but also HYPERTENSION, and ABDOMINAL OBESITY.	8.28	9	8
Metabolic Syndrome A cluster of symptoms that are risk factors for CARDIOVASCULAR DISEASES and TYPE 2 DIABETES MELLITUS. The major components of metabolic syndrome include ABDOMINAL OBESITY; atherogenic DYSLIPIDEMIA; HYPERTENSION; HYPERGLYCEMIA; INSULIN RESISTANCE; a proinflammatory state; and a prothrombotic (THROMBOSIS) state.	8.28	9	8
Arteriosclerosis, Coronary [description not available]	5.63	3	2
Coronary Artery Disease Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.	5.63	3	2
Blood Clot [description not available]	3.47	1	1
Thrombosis Formation and development of a thrombus or blood clot in the blood vessel.	3.47	1	1
Disease Exacerbation [description not available]	5.97	3	1
Insulin Sensitivity [description not available]	4.76	2	1
Insulin Resistance Diminished effectiveness of INSULIN in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent HYPERGLYCEMIA or KETOSIS.	4.76	2	1
Genetic Predisposition [description not available]	2.11	1	0
Apolipoprotein B-100, Familial Defective [description not available]	6.3	7	2
Hyperlipoproteinemia Type II A group of familial disorders characterized by elevated circulating cholesterol contained in either LOW-DENSITY LIPOPROTEINS alone or also in VERY-LOW-DENSITY LIPOPROTEINS (pre-beta lipoproteins).	6.3	7	2
Autoimmune Diabetes [description not available]	6.49	3	3
Diabetes Mellitus, Type 1 A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence.	6.49	3	3
Impaired Glucose Tolerance [description not available]	3.51	1	1
Glucose Intolerance A pathological state in which BLOOD GLUCOSE level is less than approximately 140 mg/100 ml of PLASMA at fasting, and above approximately 200 mg/100 ml plasma at 30-, 60-, or 90-minute during a GLUCOSE TOLERANCE TEST. This condition is seen frequently in DIABETES MELLITUS, but also occurs with other diseases and MALNUTRITION.	3.51	1	1
Recrudescence [description not available]	2.13	1	0
Anterior Circulation Transient Ischemic Attack [description not available]	2.13	1	0
Ischemic Attack, Transient Brief reversible episodes of focal, nonconvulsive ischemic dysfunction of the brain having a duration of less than 24 hours, and usually less than one hour, caused by transient thrombotic or embolic blood vessel occlusion or stenosis. Events may be classified by arterial distribution, temporal pattern, or etiology (e.g., embolic vs. thrombotic). (From Adams et al., Principles of Neurology, 6th ed, pp814-6)	2.13	1	0
Adverse Drug Event [description not available]	2.15	1	0
Drug-Related Side Effects and Adverse Reactions Disorders that result from the intended use of PHARMACEUTICAL PREPARATIONS. Included in this heading are a broad variety of chemically-induced adverse conditions due to toxicity, DRUG INTERACTIONS, and metabolic effects of pharmaceuticals.	2.15	1	0
Liver Dysfunction [description not available]	4.45	1	1
Benign Neoplasms [description not available]	4.79	2	1
Liver Diseases Pathological processes of the LIVER.	4.45	1	1
Neoplasms New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.	4.79	2	1
Rhabdomyolysis Necrosis or disintegration of skeletal muscle often followed by myoglobinuria.	4.45	1	1
Coronary Heart Disease [description not available]	7.91	7	5
Coronary Disease An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.	7.91	7	5
Cerebral Concussion [description not available]	2.04	1	0
Blood Pressure, High [description not available]	2.04	1	0
Brain Concussion A nonspecific term used to describe transient alterations or loss of consciousness following closed head injuries. The duration of UNCONSCIOUSNESS generally lasts a few seconds, but may persist for several hours. Concussions may be classified as mild, intermediate, and severe. Prolonged periods of unconsciousness (often defined as greater than 6 hours in duration) may be referred to as post-traumatic coma (COMA, POST-HEAD INJURY). (From Rowland, Merritt's Textbook of Neurology, 9th ed, p418)	2.04	1	0
Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.	2.04	1	0
Left Ventricular Dysfunction [description not available]	4.75	2	1
Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)	4.35	1	1
Ventricular Dysfunction, Left A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.	4.75	2	1
Calcification, Pathologic [description not available]	2.05	1	0
Calcinosis Pathologic deposition of calcium salts in tissues.	2.05	1	0
Familial Combined Hyperlipidemia [description not available]	3.43	1	1
Hyperlipidemia, Familial Combined A type of familial lipid metabolism disorder characterized by a variable pattern of elevated plasma CHOLESTEROL and/or TRIGLYCERIDES. Multiple genes on different chromosomes may be involved, such as the major late transcription factor (UPSTREAM STIMULATORY FACTORS) on CHROMOSOME 1.	3.43	1	1
Nasal Bleeding [description not available]	2.05	1	0
Hereditary Hemorrhagic Telangiectasia [description not available]	2.05	1	0
Epistaxis Bleeding from the nose.	2.05	1	0
Telangiectasia, Hereditary Hemorrhagic An autosomal dominant vascular anomaly characterized by telangiectases of the skin and mucous membranes and by recurrent gastrointestinal bleeding. This disorder is caused by mutations of a gene (on chromosome 9q3) which encodes endoglin, a membrane glycoprotein that binds TRANSFORMING GROWTH FACTOR BETA.	2.05	1	0
Liver Steatosis [description not available]	3.83	2	1
Fatty Liver Lipid infiltration of the hepatic parenchymal cells resulting in a yellow-colored liver. The abnormal lipid accumulation is usually in the form of TRIGLYCERIDES, either as a single large droplet or multiple small droplets. Fatty liver is caused by an imbalance in the metabolism of FATTY ACIDS.	3.83	2	1
Diabetic Angiopathies VASCULAR DISEASES that are associated with DIABETES MELLITUS.	6.09	3	2
ANCA-Associated Vasculitides [description not available]	2.05	1	0
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Group of systemic vasculitis with a strong association with ANCA. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls.	2.05	1	0
Chronic Kidney Failure [description not available]	2.76	3	0
Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.	2.76	3	0
Asymptomatic Conditions [description not available]	3.47	1	1
Auricular Fibrillation [description not available]	3.47	1	1
Atrial Fibrillation Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation.	3.47	1	1
Complications of Diabetes Mellitus [description not available]	6.08	3	2
Cardiac Diseases [description not available]	2.99	1	0
Heart Diseases Pathological conditions involving the HEART including its structural and functional abnormalities.	2.99	1	0
Abdominal Obesity [description not available]	3.47	1	1
Deficiency, Vitamin D [description not available]	3.47	1	1
Vitamin D Deficiency A nutritional condition produced by a deficiency of VITAMIN D in the diet, insufficient production of vitamin D in the skin, inadequate absorption of vitamin D from the diet, or abnormal conversion of vitamin D to its bioactive metabolites. It is manifested clinically as RICKETS in children and OSTEOMALACIA in adults. (From Cecil Textbook of Medicine, 19th ed, p1406)	3.47	1	1

ezetimibe, simvastatin drug combination

Description

Cross-References

Synonyms (13)

Research Excerpts

Toxicity

Pharmacokinetics

Compound-Compound Interactions

Bioavailability

Dosage Studied

Research

Studies (147)

Market Indicators

Research Demand Index: 23.93

Study Types

Clinical Trials (28)

Trial Overview

Trial Outcomes

Time to First Occurrence of Cardiovascular Death, Major Coronary Event, or Non-fatal Stroke (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)

Time to First Occurrence of Coronary Heart Disease (CHD) Death, Non-fatal MI, or Urgent Coronary Revascularization With PCI or CABG ≥ 30 Days After Randomization (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)

Time to First Occurrence of CV Death, Nonfatal MI, UA With Hospitalization, All Revascularization Occurring ≥30 Days After Randomization, and Non-fatal Stroke (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)

Time to First Occurrence of Death From Any Cause, Major Coronary Event, or Non-fatal Stroke (Kaplan-Meier Estimate of Percentage of Participants Experiencing a Qualifying Event)

Percent Change From Baseline in Low-Density Lipoprotein-Cholesterol (LDL-C)

Percent Change From Baseline in Low-Density Lipoprotein-Cholesterol (LDL-C)

Percent Change From Baseline in Low-Density Lipoprotein-Cholesterol (LDL-C)

Percent Change From Baseline in High-Density Lipoprotein-Cholesterol (HDL-C)

Percent Change From Baseline in High-Density Lipoprotein-Cholesterol (HDL-C)

Percent Change From Baseline in Non-High-Density Lipoprotein-Cholesterol (Non-HDL-C)

Percent Change From Baseline in Non-High-Density Lipoprotein-Cholesterol (Non-HDL-C)

Percent Change From Baseline in Non-High-Density Lipoprotein-Cholesterol (Non-HDL-C)

Percent Change From Baseline in Triglycerides (TG)

Percent Change From Baseline in Triglycerides (TG)

Change in Low-density-lipoprotein Cholesterol (LDL-C) at 6 Weeks

Stroke

Coronary or Non-coronary Revascularisation

Major Coronary Events

Major Vascular Event

Mortality

Change in LDL-c From Baseline to 6 Months in Subjects With Type 1 Diabetes Taking Vytorin or Zocor.

LDL Cholesterol

Total Cholesterol

Percent Change From Baseline in Apolipoprotein B

Percent Change From Baseline in Apolipoprotein B/A-1 Ratio

Percent Change From Baseline in High-sensitivity C-Reactive Protein (Hs-CRP)

Percent Change From Baseline in LDL-Cholesterol/HDL-Cholesterol Ratio

Percent Change From Baseline in Low Density Lipoprotein (LDL)-C

Percent Change From Baseline in Non-HDL Cholesterol

Percent Change From Baseline in Non-HDL Cholesterol/HDL-Cholesterol Ratio

Percent Change From Baseline in Total Cholesterol

Percent Change From Baseline in High-Density Lipoprotein (HDL) Cholesterol

Percent Change From Baseline in Triglycerides

Percent Change From Baseline in Total Cholesterol/HDL-Cholesterol Ratio

Number of Participants Reaching LDL-C Target Goal <100 mg/dL

Number of Participants Reaching LDL-C Target Goal <77 mg/dL

Number of Participants Reaching LDL-C Target Goals of <70 mg/dL

Percent Change From Baseline in Apolipoprotein A-1

Ex Vivo Effects of Treatment With Vytorin Versus Zocor for 6 Weeks on Platelet Alpha Thrombin PAR-1 Receptor Expression

Biomarkers of Inflammation

Number of Participants Who Had an Adverse Event (AE).

L5 Concentration in Metabolic Syndrome Patients

L5 Concentration After Treatment of Ezetimibe, Simvastatin, or Vytorin in Metabolic Syndrome Patients

Apolipoprotein B Before and After Simvastatin/Ezetimibe Administration

High-density Lipoprotein Cholesterol (HDLc) Before and After Simvastatin/Ezetimibe Administration

Leukocyte Adhesion Before and After Simvastatin/Ezetimibe Administration

Leukocyte Rolling Flux Before and After Simvastatin/Ezetimibe Administration

Leukocyte Rolling Velocity Before and After Simvastatin/Ezetimibe Administration

Levels of E-selectin Before and After Simvastatin/Ezetimibe Administration

Levels of Glutathione (GSH) Before and After Simvastatin/Ezetimibe Administration

Levels of High-sensitive C-reactive Protein (hsCRP) Before and After Simvastatin/Ezetimibe Administration

Levels of Intercellular Adhesion Molecule 1 (ICAM-1) Before and After Simvastatin/Ezetimibe Administration

Levels of Interleukin-6 (IL-6) Before and After Simvastatin/Ezetimibe Administration

Levels of Tumor Necrosis Factor α (TNF-α) Before and After Simvastatin/Ezetimibe Administration

Levels of Vascular Cell Adhesion Molecule 1 (VCAM-1) Before and After Simvastatin/Ezetimibe Administration

Low Density Lipoprotein Size Before and After Simvastatin/Ezetimibe Administration

Low-density Lipoprotein Cholesterol (LDLc) Before and After Simvastatin/Ezetimibe Administration

Membrane Potential Before and After Simvastatin/Ezetimibe Administration

Mitochondrial Oxygen (O2) Consumption Before and After Simvastatin/Ezetimibe Administration

Non-HDL Cholesterol Before and After Simvastatin/Ezetimibe Administration

Reactive Oxygen Species (ROS) Production Before and After Simvastatin/Ezetimibe Administration

Total Cholesterol Before and After Simvastatin/Ezetimibe Administration