Vytorin: The Facts
Written by Joan Stelzner, ARNPEdited by Hector Fontanet, M.D., FACC
January 31, 2008
Updated April 2, 2008
Vytorin is a medication prescribed to treat high cholesterol4¹ and to prevent heart attacks and strokes. Vytorin contains Simvastatin (Zocor) and Ezetimibe (Zetia), both of which help to lower cholesterol through two different mechanisms. Simvastation lowers cholesterol by decreasing the production of cholesterol within the liver. Ezetimibe lowers cholesterol by blocking the absorption of cholesterol within the intestine.
Recently the first phase of a clinical drug trial (ENHANCE) comparing Vytorin with Simvastatin produced some unexpected findings. The belief was that by adding Estemide to Simvastatin it would produce a greater reduction in cholesterol, which in turn would result in the slowing of cholesterol build-up (plaque) within blood vessels. This is important because we know that when blood vessels become clogged with plaque it can result in a heart attack or stroke. In the ENHANCE study, cholesterol plaque build-up was measured by evaluating existing plaques within carotid arteries (neck arteries) via ultrasound over the course of 24 months. The results revealed that Vytorin did not perform better than Simvastatin alone in slowing the build-up of plaque in spite of a greater reduction in cholesterol levels. This is not to say that Vytorin is not a good drug or harmful. It simply failed to be better at slowing plaque formation than Simvastatin alone despite being more effective at reducing the blood cholesterol.
What does this mean to people on Vytorin? Basically nothing. One must remember that the reason a health care provider places a patient on Vytorin is to reduce cholesterol, and to prevent heart attacks and strokes. The bottom line is that Vytorin does all of these things very effectively. As long as your health care provider has determined that you have reached your target cholesterol level and you are not having any side effects from Vytorin, then there is no reason to change to another drug. However, in some patients it may be reasonable to switch from Vytorin to less expensive or generic statins. Patients should discuss any concerns with their health care provider before stopping any medication or to find out if they would receive the same benefit by switching to an alternate statin.
