Zetia interactions: Alcohol, medications, and other factors

Before you start treatment with Zetia, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Zetia interacts with supplements, herbs, or vitamins, see the “Zetia and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Zetia. Keep in mind that this table doesn’t include all drugs that may interact with Zetia. Some of these interactions are described in detail just below in “Drug interactions in depth.”

In some cases, factors or conditions could prevent your doctor from prescribing Zetia due to the risk of harm. These are known as contraindications. The contraindications of Zetia include:

Having had an allergic reaction to Zetia or any of its ingredients

If you have had an allergic reaction to Zetia or any of its ingredients, your doctor will likely not prescribe Zetia. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Zetia is sometimes used with other cholesterol-lowering drugs, such as statins or fenofibrate. Your doctor will likely not prescribe Zetia with other cholesterol-lowering drugs if you have contraindications to these drugs. Your doctor will take your health history into account when deciding whether to prescribe Zetia with other drugs or on its own.

There aren’t any known interactions between Zetia (ezetimibe) and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Zetia treatment.

This is because drinking alcohol while taking the drug may worsen some of Zetia’s side effects. For example, you may experience diarrhea, dizziness, and fatigue.

In addition, consuming large amounts of alcohol can cause liver damage. Zetia may cause high levels of liver enzymes as a side effect.* High liver enzymes can be a sign of liver damage. This means that drinking alcohol during Zetia treatment may increase the risk of liver problems.

If you have questions about drinking alcohol while taking Zetia, talk with your doctor.

* For details about Zetia’s side effects, see this article.

Here’s a closer look at certain drug interactions of Zetia.

Fibrates

Zetia can interact with fibrates, which are a group of drugs used to help lower high cholesterol and triglycerides.

Interaction result: Taking Zetia with a fibrate medication can raise your risk of developing gallstones.

Interaction explained: If you have a high level of cholesterol in your bile, the cholesterol can solidify in your gallbladder and form gallstones. (Bile is stored in your gallbladder.) Zetia and fibrates can both increase the amount of cholesterol in your bile. So taking these medications together can increase the risk of gallstones forming.

Examples of fibrate drugs: Here are some fibrates that may interact with Zetia:

• fenofibrate (Lipofen, others)
• fenofibric acid (Trilipix)
• gemfibrozil (Lopid)

Steps you or your doctor may take: Zetia is approved for use with fenofibrate. Your doctor may prescribe Zetia with fenofibrate to help lower your cholesterol.

If you take Zetia with fenofibrate, tell your doctor if you have symptoms of gallstones. These include sudden, worsening pain in your upper right abdomen, right shoulder, or between your shoulder blades. You may also have nausea, vomiting, or sweating.

Zetia hasn’t been studied with other fibrates and isn’t approved for use with other fibrates. Your doctor likely will not prescribe Zetia with gemfibrozil.

If you have questions about taking Zetia with a fibrate, talk with your doctor or pharmacist.

Bile acid sequestrants

Zetia can interact with bile acid sequestrants, which are another group of drugs used to help lower cholesterol levels.

Interaction result: Taking Zetia around the same time of day as a bile acid sequestrant can make Zetia less effective.

Interaction explained: Bile acid sequestrants can combine with Zetia in your intestine. Taking Zetia around the same time of day as a bile acid sequestrant can reduce the amount of Zetia that gets absorbed into your bloodstream. This can make Zetia less effective.

Examples of bile acid sequestrant drugs: Here are some bile acid sequestrants that may interact with Zetia:

• cholestyramine (Prevalite, Locholest)
• colesevelam (Welchol)
• colestipol (Colestid)

Steps you or your doctor may take: If your doctor prescribes Zetia with a bile acid sequestrant, talk with your doctor or pharmacist about when you should take your doses. You should usually take Zetia at least 2 hours before or 4 hours after taking the bile acid sequestrant.

If you have questions about taking Zetia with a bile acid sequestrant, talk with your doctor or pharmacist.

Cyclosporine (Neoral, others)

Zetia can interact with cyclosporine, which is an immunosuppressant drug used to treat autoimmune conditions such as psoriasis and rheumatoid arthritis. It’s also used to help prevent rejection of organ transplants.

Interaction result: Taking Zetia with cyclosporine can raise your risk of side effects* from both medications.

Interaction explained: Taking Zetia with cyclosporine can increase the level of both medications in your body. This can raise your risk of side effects from both medications.

Steps you or your doctor may take: If your doctor prescribes Zetia with cyclosporine, they may prescribe a dosage of one or both medications that’s lower than usual. Do not take a higher dosage of either medication than your doctor prescribes.

If you take Zetia with cyclosporine, your doctor may order blood tests to monitor the level of cyclosporine in your blood.

Tell your doctor if you have new, increased, or bothersome side effects when taking Zetia with cyclosporine.

If you have questions about taking these medications together, talk with your doctor or pharmacist.

* For details about Zetia’s side effects, see this article. For more information about cyclosporine’s side effects, see this article.

Zetia may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Zetia.

Zetia interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Zetia and herbs

There are no specific reports of herbs interacting with Zetia. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Zetia treatment.

Zetia and vitamins

There are no specific reports of vitamins interacting with Zetia. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Zetia.

Zetia and food

There were no specific reports of food interactions with Zetia. If you’d like to learn more about eating certain foods during treatment with Zetia, talk with your doctor.

Zetia and vaccines

There aren’t any known interactions between Zetia and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Zetia interactions with lab tests

Zetia isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

ZETIA INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Zetia. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Zetia. The impact of cannabis may affect how well you stick to your Zetia treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Zetia. Before you take this drug, be sure to talk with your doctor about your health history. Zetia may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Zetia include:

• Liver problems: If you have a liver problem, Zetia may build up in your body. This can raise your risk of side effects* from the medication. Taking Zetia could also make your liver problem worse, especially if you take Zetia with a statin medication. Your doctor will likely not prescribe Zetia if you have moderate or severe liver problems. You can ask your doctor about other treatment options.
• Kidney problems: Zetia can rarely cause side effects on your muscles. If you have a kidney problem and you take Zetia with a statin medication, you may have a higher risk of muscle side effects.*
• Hypothyroidism: Zetia can rarely cause side effects on your muscles. If you have hypothyroidism (low thyroid hormone levels) and you take Zetia with a statin medication, you may have a higher risk of muscle side effects.
• Allergic reaction: If you’ve had an allergic reaction to Zetia or any of its ingredients, your doctor will likely not prescribe Zetia. This is a Zetia contraindication. For more information, see the “When to avoid Zetia” section above.
• Breastfeeding: It’s not known whether it’s safe to use Zetia while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Zetia may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Zetia. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Zetia is safe to use while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Zetia. They can advise you on the right treatment plan for you.

* For details about Zetia’s side effects, see this article.

You can take certain steps to help prevent interactions with Zetia. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Zetia label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Zetia doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Zetia by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Zetia. These resources might help:

• Overview of Zetia: For a general overview of Zetia, you can see this article.
• Side effects: If you’re interested in the side effects of Zetia, see this article. Another option is to refer to the Zetia prescribing information.
• Dosage specifics: To learn about the dosage of Zetia, see this article.
• Facts about your condition: To learn more about the conditions Zetia is used to treat, see our cholesterol and cardiovascular health hubs.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.