Ezetimibe reduces the amount of cholesterol absorbed by the body. Simvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins."

Ezetimibe and simvastatin is a combination medicine that is used to lower blood levels of "bad" cholesterol (low-density lipoprotein, or LDL), to increase levels of "good" cholesterol (high-density lipoprotein, or HDL), and to lower triglycerides (a type of fat in the blood).

Ezetimibe and simvastatin is used together with a low-fat diet and other treatments to lower total cholesterol in adults and children who are at least 10 years old. It is not known whether ezetimibe and simvastatin reduces your risk of heart disease.

Ezetimibe and simvastatin may also be used for purposes not listed in this medication guide.

You should not use ezetimibe and simvastatin if you have active liver disease or abnormal liver function tests.

Do not use ezetimibe and simvastatin if you are pregnant or breastfeeding.

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take ezetimibe and simvastatin in the evening, with or without food.

You will need frequent medical tests.

Make sure any doctor caring for you knows you that you use ezetimibe and simvastatin, especially if you have an infection, injury or surgery.

Ezetimibe and simvastatin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your doctor's instructions very closely.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

You should not use this medicine if you are allergic to simvastatin (Zocor) or ezetimibe (Vytorin, Zetia), or if you have:

• active liver disease; or

• abnormal liver function tests.

Do not use if you are pregnant. This medicine can harm an unborn baby. Use effective birth control to prevent pregnancy. Stop taking this medicine and tell your doctor at once if you become pregnant.

Do not breastfeed while taking ezetimibe and simvastatin.

Ezetimibe and simvastatin can cause the breakdown of muscle tissue, which can lead to kidney failure. This happens more often in women, in older adults, in people of Chinese descent, and in people who have kidney disease or poorly controlled hypothyroidism (underactive thyroid).

Other medicines may increase your risk of serious muscle problems if you take them together with ezetimibe and simvastatin. Do not take these medicines at the same time:

• cyclosporine;

• danazol;

• gemfibrozil;

• nefazodone;

• an antibiotic--clarithromycin, erythromycin, telithromycin;

• antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole;

• hepatitis C medications--boceprevir, telaprevir; or

• HIV/AIDS medication--atazanavir, cobicistat, indinavir, nelfinavir, ritonavir, saquinavir, tipranavir.

Your doses of certain other medicines may need to be adjusted while you are taking ezetimibe and simvastatin. This includes:

• amiodarone or dronedarone;

• amlodipine (sometimes in combination medicines--Azor, Caduet, Consensi, Exforge, Lotrel, Prestalia, Twynsta, Tribenzor);

• colchicine;

• diltiazem, verapamil;

• fenofibrate, fenofibric acid;

• lomitapide;

• ranolazine; or

• medicines that contain niacin, nicotinic acid, or vitamin B3, such as Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others.

Tell your doctor if you have ever had:

• unexplained weakness or muscle pain;

• a thyroid disorder;

• liver or kidney disease;

• liver problems caused by alcohol;

• a habit of drinking more than 2 alcoholic drinks per day; or

• if you are older than 65.

Ezetimibe and simvastatin is not approved for use by anyone younger than 10 years old.

This medicine should not be given to a girl who has not yet had menstrual periods.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Grapefruit may interact with ezetimibe and simvastatin and lead to unwanted side effects. Avoid the use of grapefruit products.

Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage.

Avoid eating foods high in fat or cholesterol, or ezetimibe and simvastatin will not be as effective.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

This medicine may cause serious side effects. Stop using this medicine and call your doctor at once if you have:

• unexplained muscle pain, tenderness, or weakness;

• muscle weakness in your hips, shoulders, neck, and back;

• trouble lifting your arms, trouble climbing or standing;

• fever, unusual tiredness;

• upper stomach pain, loss of appetite;

• dark colored urine; or

• jaundice (yellowing of the skin or eyes).

Common side effects of ezetimibe and simvastatin may include:

• headache;

• muscle pain;

• abnormal liver function tests;

• diarrhea; or

• cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

If you also take cholestyramine, colesevelam, or colestipol: Take your ezetimibe and simvastatin dose 2 hours before or 4 hours after you take the other medicine.

Tell your doctor about all your current medicines. Many drugs can affect ezetimibe and simvastatin, especially:

• a blood thinner such as warfarin, Coumadin, or Jantoven; or

• heart or blood pressure medication.

This list is not complete and many other drugs may affect ezetimibe and simvastatin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.