Are there any side effects of ezetimibe?

Ezetimibe lowers cholesterol by blocking its absorption in the small intestine.

What are the most common side effects people report?
Upper respiratory tract infections, diarrhea, joint pain, and fatigue occur most often. Muscle aches also appear in some patients, though less frequently than with statins.

Can ezetimibe cause muscle or liver problems?
Myalgia and elevated liver enzymes have been documented in clinical studies. These effects are milder than those seen with statins, but monitoring is still advised when the drug is taken with a statin.

What happens if ezetimibe is taken with other cholesterol drugs?
Combination therapy increases the chance of muscle pain and liver-enzyme changes. Doctors usually check liver function before starting and periodically afterward.

Are there any rare but serious reactions?
Hypersensitivity reactions, including rash, swelling, and breathing difficulty, have been reported. Pancreatitis and gallstones appear in post-marketing data, though both remain uncommon.

Does ezetimibe affect absorption of vitamins or other medicines?
It can reduce uptake of fat-soluble vitamins if taken at very high doses, but standard doses rarely cause clinically significant deficiencies. It may also interact with cyclosporine, fibrates, and warfarin, requiring dose adjustments or closer monitoring.

When do side effects usually appear?
Most gastrointestinal and muscle complaints surface within the first few weeks. Liver-related changes can develop later, so follow-up blood tests are recommended at 6–12 weeks and then annually if stable.

Who should avoid or use extra caution with ezetimibe?
Patients with active liver disease or unexplained persistent elevations in liver enzymes should not start the drug. Those with moderate or severe kidney impairment need dose adjustments when combined with a statin.

Sources:
[1] https://www.drugpatentwatch.com/drugs/ezetimibe