Cholesterol absorption inhibitor · Lipid-lowering therapy
KDIGO 2024 + manufacturer label
22 branded formulations and 14 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Selectively inhibits intestinal NPC1L1 transporter, blocking absorption of dietary and biliary cholesterol → reduced hepatic cholesterol stores, upregulated LDL receptors and lowered LDL-C; complementary to statins.
Avoid (especially with a statin) — discontinue if pregnancy planned/confirmed
Avoid (excreted in animal milk)
Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.
Consider using pravastatin, fluvastatin, or rosuvastatin, as they are not extensively metabolized by CYP3A4. Carefully weigh the benefits against the risk of myopathy.
Source: G&G 14e · p736
Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.
Consider using pravastatin, fluvastatin, or rosuvastatin, as they are not extensively metabolized by CYP3A4. Carefully weigh the benefits against the risk of myopathy.
Source: G&G 14e · p736
Increased risk of myopathy and rhabdomyolysis.
Concomitant use should be avoided or used with extreme caution, especially for statins metabolized by CYP3A4. Dose reduction of the statin and vigilant monitoring for muscle symptoms are necessary.
Source: KDT 7e · p637
Increased risk of myopathy and rhabdomyolysis.
Concomitant use should be avoided or used with extreme caution, especially for statins metabolized by CYP3A4. Dose reduction of the statin and vigilant monitoring for muscle symptoms are necessary.
Source: KDT 7e · p637
Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.
Consider using pravastatin, fluvastatin, or rosuvastatin, as they are not extensively metabolized by CYP3A4. Carefully weigh the benefits against the risk of myopathy. For simvastatin, coadministration is contraindicated.
Source: G&G 14e · p736
Increased risk of myopathy and rhabdomyolysis.
Concomitant use should be avoided or used with extreme caution, especially for statins metabolized by CYP3A4. Dose reduction of the statin and vigilant monitoring for muscle symptoms are necessary.
Source: KDT 7e · p637
Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.
Consider using pravastatin, fluvastatin, or rosuvastatin, as they are not extensively metabolized by CYP3A4. Carefully weigh the benefits against the risk of myopathy. For simvastatin, coadministration is contraindicated.
Source: G&G 14e · p736
Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.
Consider using pravastatin, fluvastatin, or rosuvastatin, as they are not extensively metabolized by CYP3A4. Carefully weigh the benefits against the risk of myopathy.
Source: G&G 14e · p736
Increased risk of myopathy.
Avoid coadministration. The FDA withdrew approval for statin drug combinations containing niacin in 2016.
Source: G&G 14e · p736
Increased risk of myopathy and rhabdomyolysis.
A lower dose of statin is advisable when nicotinic acid is given concurrently. Close monitoring for muscle symptoms is essential.
Source: KDT 7e · p637, p640
Markedly increased ezetimibe (and ciclosporin) exposure
Monitor ciclosporin levels; use lowest ezetimibe dose, caution
Source: Kimi deep-research + Cla
Reduced risk of rhabdomyolysis compared to other fibrate-statin combinations, but vigilance for myopathy is still advised due to class effect.
This combination is generally considered safer than statin-gemfibrozil, but practitioners should still exercise caution and monitor for muscle symptoms.
Source: KDT 7e · p639
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19