Vytorin

What is the most important information I should know about Vytorin?
• Do not stop taking Vytorin unless directed to do so by your doctor. It may be weeks or months before beneficial effects are seen from this medication.
• Rare cases of muscle problems and liver problems have been associated with the use of Vytorin and other similar medicines. Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if accompanied by a fever or flulike symptoms or yellowing of the skin or eyes, abdominal pain, unexplained fatigue, dark colored urine or pale colored stools. These may be early symptoms of muscle or liver problems.
• Do not take Vytorin without first talking to your doctor if you have liver disease.
• Alcohol and Vytorin can both be damaging to the liver. Alcohol should be used only in moderation. Discuss the use of alcohol with your doctor so that the potential for liver problems can be determined.
• Do not take Vytorin if you are pregnant, could become pregnant during treatment, or if you are breast-feeding a baby.




What is Vytorin?
• Vytorin reduces the amount of cholesterol (a type of fat) absorbed by the body and blocks the production of cholesterol in the body.
• Vytorin is used to reduce the total amounts of cholesterol, LDL (bad) cholesterol, triglycerides (another type of fat), and apolipoprotein B (a protein needed to make cholesterol) in your blood. Vytorin is also used to increase the level of HDL (good) cholesterol in your blood. These actions may reduce the risk of hardening of the arteries, which can lead to heart attacks, stroke, and peripheral vascular disease.
• Vytorin may also be used for purposes other than those listed in this medication guide.




What should I discuss with my healthcare provider before taking Vytorin?
• Before taking Vytorin, tell your doctor if you
· have liver or kidney disease;
· drink alcoholic beverages;
· have hypothyroidism (low thyroid function);
· have a chronic muscular disease or have unexplained muscle pain, tenderness, or weakness;
· are taking another cholesterol-lowering medication; or
· have a blood disorder.
• You may not be able to take Vytorin, or you may require a dosage adjustment or special monitoring during treatment.
• Vytorin is in the FDA pregnancy category X. This means that Vytorin is known to cause birth defects if it is taken during pregnancy. Do not take Vytorin if you are pregnant or could become pregnant during treatment.
• It is not known whether Vytorin passes into breast milk. Do not take simvastatin without first talking to your doctor if you are breast-feeding a baby.




How should I take Vytorin?
• Take Vytorin exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take Vytorin once a day with or without food. It may be easier to remember to take the medication if you take it at the same time every day.
• Vytorin should be taken 2 hours before or 4 hours after a bile acid sequestrant such as cholestyramine (Locholest, Prevalite, Questran), colestipol (Colestid), or colesevelam (Welchol).
• Your doctor may want to monitor cholesterol levels, liver function, or other factors with blood tests before starting and during treatment with Vytorin. Depending on the results of these tests, your doctor can determine how much monitoring you will require.
• Do not stop taking Vytorin unless directed to do so by your doctor. It may be weeks or months before beneficial effects are seen from this medication.
• Store Vytorin at room temperature away from moisture and heat.




What happens if I miss a dose?
• Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of the medication.




What happens if I overdose?
• Seek emergency medical attention if an overdose is suspected.
• Symptoms of an Vytorin overdose may include nausea, diarrhea, stomach distress, and indigestion..




What should I avoid while taking Vytorin?
• Eat a low-fat, low-cholesterol diet. To see beneficial effects from Vytorin avoid fatty, high-cholesterol foods.
• Grapefruit and grapefruit juice may interact with Vytorin. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
• Both alcohol and ezetimibe/simvastatin can be damaging to the liver. Alcohol should be used only in moderation. Discuss the use of alcohol with your doctor so that the potential for liver problems can be determined.
• Avoid prolonged exposure to sunlight or artificial UV light (e.g., tanning beds). Vytorin may increase the sensitivity of the skin to sunlight, and burning may result. Wear protective clothing and sunscreen if exposure to the sun is unavoidable.




What are the possible side effects of Vytorin?
• Rare cases of muscle problems and liver problems have been associated with the use of Vytorin and other similar medicines. Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if accompanied by a fever or flulike symptoms or yellowing of the skin or eyes, abdominal pain, unexplained fatigue, dark colored urine or pale colored stools. These may be early symptoms of muscle or liver problems.
• If you experience any of the following serious side effects, stop taking Vytorin and seek emergency medical attention or contact your doctor immediately:
· an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
· decreased urine or rust-colored urine; or
· blurred vision.
• Other, less serious side effects may be more likely to occur. Continue to take Vytorin and talk to your doctor if you experience
· gas, bloating, nausea, stomach upset, heartburn, abdominal pain, constipation, or diarrhea;
· cough;
· tiredness;
· headache; or
· insomnia.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.




What other drugs will affect Vytorin?
• Do not take Vytorin without first talking to your doctor if you are taking any of the following medicines:
· cyclosporine (Sandimmune, Neoral);
· atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altocor, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) or simvastatin (Zocor);
· gemfibrozil (Lopid), fenofibrate (Tricor) or clofibrate (Atromid-S);
· niacin (Nicolar, Nicobid, Slo-Niacin, others);
· erythromycin (E-Mycin, E.E.S., Ery-Tab, others), telithromycin (Ketek) or clarithromycin (Biaxin);
· cholestyramine (Questran) or colestipol (Colestid);
· an antifungal medication such as itraconazole (Sporanox), fluconazole (Diflucan), or ketoconazole (Nizoral);
· nefazodone (Serzone);
· digoxin (Lanoxin, Lanoxicaps);
· warfarin (Coumadin);
· a protease inhibitor such as amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), lopinavir-ritonavir (Kaletra), or saquinavir (Invirase, Fortovase);
· amiodarone (Cordarone, Pacer one); or
· verapamil (Calan, Covera-HS, Isoptin, Verelan).
• You may not be able to take Vytorin, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with Vytorin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.