From the Guidelines
The patient should contact their healthcare provider about the headache and sinus congestion that developed after starting Zetia (ezetimibe), as these symptoms could be side effects of the medication, although they are not among the most common side effects reported for Zetia 1.
Possible Side Effects of Zetia
According to the 2022 ACC expert consensus decision pathway, the common adverse effects of ezetimibe monotherapy include upper respiratory tract infection, diarrhea, arthralgia, sinusitis, and pain in extremities 1. While headache and sinus congestion are not explicitly listed as common side effects, they could be related to the upper respiratory tract infection or sinusitis reported in some patients.
Management of Side Effects
The patient can try over-the-counter pain relievers like acetaminophen for the headache and a saline nasal spray for sinus congestion, as long as these don't conflict with other medications or conditions 1.
Importance of Continuing Medication
The patient should not stop taking Zetia without medical advice, as it's an important cholesterol-lowering medication that works by reducing cholesterol absorption in the intestine 1.
Alternative Treatments
Their doctor might recommend continuing the medication if the side effects are mild and temporary, or might consider alternatives like statins or PCSK9 inhibitors if the side effects persist 1. The timing of symptom onset after starting Zetia suggests a possible connection, but other causes like seasonal allergies or viral infections should also be considered.
Key Considerations
- The patient's healthcare provider should be consulted before making any changes to their medication regimen.
- The benefits of continuing Zetia should be weighed against the potential side effects.
- Alternative treatments, such as statins or PCSK9 inhibitors, may be considered if the side effects of Zetia are severe or persistent 1.
From the FDA Drug Label
The most common side effects of ezetimibe tablets taken alone include: upper respiratory tract infection joint pain pain in arms or legs flu-like symptoms diarrhea inflammation of the sinuses feeling tired
Headache is listed as a possible side effect of ezetimibe tablets in the post-marketing experience section, and sinusitis (inflammation of the sinuses) is listed as a common side effect. Sinus congestion is not explicitly listed, but upper respiratory tract infection and sinusitis are related conditions that may involve sinus congestion. Therefore, headache is a side effect of taking Zetia (ezetimibe), and sinus congestion may be related to the listed side effects of upper respiratory tract infection and sinusitis 2 2.
From the Research
Side Effects of Zetia (Ezetimibe)
- The side-effect profile of ezetimibe resembles that of placebo when given as monotherapy or in combination with statins 3
- Adverse effects associated with ezetimibe use are few and mild without having been associated with serious clinical outcomes 4
- Ezetimibe has been associated with mild elevations of liver transaminases, mainly in combination with a statin 4
- Other side effects are extremely rare, and there are no long-term safety data or outcome studies for ezetimibe yet 4
Headache and Sinus Congestion
- There is no direct evidence in the provided studies that links headache and sinus congestion as a side effect of taking Zetia (ezetimibe)
- However, it is noted that sinusitis rarely causes headache, let alone facial pain, except when there is an acute bacterial infection 5
- The co-administration of statin and ezetimibe was generally well tolerated, with no specific mention of headache and sinus congestion as side effects 6, 7
Safety of Ezetimibe
- The safety of coadministration of ezetimibe with statins has been evaluated in several studies, and the results show that it is generally well tolerated 6, 7
- A meta-analysis of 20 randomized controlled trials found that coadministration of ezetimibe and statins did not result in significant increases in total adverse events, serious adverse events, or treatment discontinuations 7