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Ezetimibe also known by the Trade name Zetia is a drug that aims to lower cholesterol. It acts by decreasing cholesterol absorption in the intestine. It may be used alone (marketed as Zetia or Ezetrol), when other cholesterol-lowering medications are not tolerated, or together with statins (e.g., ezetimibe/simvastatin, marketed as Vytorin and Inegy) when statins alone do not control cholesterol.

Even though ezetimibe decreases cholesterol levels, the results of two major, high-quality clinical trials (in 2008 and 2009) showed that it did not improve clinically significant outcomes, such as major coronary events, and actually made some outcomes, such as artery wall thickness, worse. Indeed, a panel of experts concluded in 2008 that it should "only be used as a last resort". In one of those studies, a head-to-head trial in 2009, a much less expensive medication (extended-release niacin) was found to be superior. Ezetimibe actually increased the thickness of artery walls (a measurement of atherosclerosis) and caused more major cardiovascular events. However, in combination with simvastatin, a 2010 trial has shown it to be better than atorvastatin and rosuvastatin at lowering lipid levels.

Adverse drug reactions associated with ezetimibe therapy include: headache, diarrhea, myalgia, raised liver function test (ALT/AST) results, rash, and angioedema. In 2005, the manufacturer of Ezetrol issued a warning through Health Canada associating Ezetrol (ezetimibe) with "myalgia, rhabdomyolysis, hepatitis, pancreatitis, and thrombocytopenia" and longer clotting times if the patient was on warfarin. It is probably these side effects that cause the hallucinations

“Due to insufficient data, the manufacturer does not recommend ezetimibe for patients with moderate to severe hepatic impairment”

The ENHANCE trial of Vytorin (ezetimibe and simvastatin) was designed to show that ezetimibe could reduce the growth of fatty plaques in arteries. Instead, it reported in 2008 that ezetimibe resulted in growth of plaque. The ENHANCE trial was not a clinical-outcome trial, but an imaging study of the thickness of plaque in arteries.

Since in the ENHANCE trial ezetimibe didn't reduce cardiovascular events, atherosclerosis or death, despite the reduction in LDL, doctors have been trying to figure out whether it has any use. Doctors have also concluded that reducing LDL doesn't always reduce atherosclerosis.

The results from the other trials will be presented in the future. However even before completion of ARBITER 6–HALTS, a March 30, 2008 meeting of the ACC resulted in negative press for drugs like Zetia as Yale University Cardiologist Harlan Krumholz and concurring colleagues called into question the efficacy of such drugs. Krumholz stated that these pharmaceuticals should not be the first or even second option for prescribing doctors. Results of the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial (ClinicalTrials.gov number, NCT00092677 [ClinicalTrials.gov] ) showed a potential increase in cancer in association with the use of these drugs together. (www.nejm.org September 2, 2008 (10.1056/NEJMe0807200). The actual significance has yet to be determined.

Time on Zetia when people have Hallucination  :

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