Abstract
The FDA approved ezetimibe/simvastatin July 23, 2004 and became available as a non-formulary agent within the Veterans Health Administration (VHA). Local guidelines and a template were implemented for requesting ezetimibe/simvastatin for patients intolerant to or failing first-line hypolipemic agents, primarily HMG-CoA reductase inhibitors, a.k.a. statins. Several studies show ezetimibe/simvastatin is more effective at lowering LDL than statin monotherapy because it offers a dual mechanism of action. Split ezetimibe/simvastatin 10/80 mg tablets also cost less to the VHA than maximum dose HMG-CoA reductase inhibitors. Initial data suggest the off-label ezetimibe/simvastatin 5/40 mg daily dose effectively lowers LDL.
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