Ezetimibe-induced hyperlipidaemia.
Ezetimibe is intestinally active cholesterol absorption inhibitor used to reduce low-density lipoprotein-cholesterol levels. This case report describes a novel side effect with this agent: ezetimibe-induced hyperlipidaemia in a patient with statin intolerance and familial combined hyperlipidaemia. Ezetimibe therapy induced an asymptomatic 770% increase in triglycerides (TGs) (3.51-27.1 mmol/l) and a 190% increase in total cholesterol (9.8-18.5 mmol/ 1) secondary to an increase (4.6-25.9 micromol/l; 560%) in hepatic cholesterol (lathosterol) synthesis. This lipid profile resolved 9 months after cessation of ezetimibe therapy. This report shows that ezetimibe may have long-lasting effects in man far exceeding its plasma half-life and that ezetimibe monotherapy can induce a large increase in hepatocyte very-low-density lipoprotein synthesis in rare individuals with a consequent mixed hyperlipidaemia or possibly hypercholesterolaemia depending on the metabolism and clearance of TG-rich lipoproteins.
Doherty
E
E
Department of Diabetes, St. Thomas' Hospital, London, UK.
Lumb
P J
PJ
Chik
G
G
Wierzbicki
A S
AS
D000924:Anticholesteremic Agents / Q000009:adverse effects*; D001384:Azetidines / Q000009:adverse effects*; D002784:Cholesterol / Q000097:blood; D000069438:Ezetimibe; D005260:Female; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000097:blood / Q000188:drug therapy; D006949:Hyperlipidemias / Q000139:chemically induced*; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D001384:Azetidines; D014280:Triglycerides; D002784:Cholesterol; D000069438:Ezetimibe