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Many have heard the media firestorm about the effectiveness of the 2 cholesterol lowering agents Vytorin and Zetia. There is much confusion with patients currently taking these medications regarding what they should do about their current therapy. First lets go over a little background information.
Vytorin is a medication made up of 2 agents used to lower the "bad" cholesterol. One of those agents is the brand name Zocor, which belongs to the statin class of drugs. The statins are the most effective agents available at lowering the bad cholesterol. Other agents in this class are Lipitor, Crestor, Mevacor, and Pravachol. The other agent in Vytorin is the Zetia. Now, Zetia works differently than the statins to lower the bad cholesterol. Also, Zetia is not as effective at lowering bad cholesterol as the statins.
There are multiple reasons physicians prescribe Zetia. When a patient is taking the maximum safe dose of a statin and their bad cholesterol is still above their goal, then the patient can start Zetia to lower their bad cholesterol further and possibly reach their goal. Zetia also can be used in patients who have trouble tak
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ing the statin drugs due to the serious adverse effects associated with their use, such as muscle pain/weakness.
Vytorin is used when a patient needs the benefits of both a statin and Zetia. Vytorin combines both of these agents in one pill which is much easier for a patient to take
Now onto the reason many people question whether or not to continue taking their Vytorin or Zetia. The results of a recent study were released in January. The study was titled ENHANCE, and was aimed at determining whether or not Vytorin was more beneficial than Zocor at decreasing certain risk factors associated with heart disease. The study was not designed to evaluate cardiovascular events (heart attack, stroke). The study found that Vytorin decreased overall bad cholesterol by a greater percentage than the Zocor alone. However, Vytorin and Zocor reduced certain risk factors associated with heart disease by the same percentage.
There are a few problems with this study, which the media failed to recognize. First of all, the study was only 2
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years in duration and did not cardiovascular outcomes (heart attack, stroke). There is currently a study titled IMPROVE-IT underway which assesses cardiovascular outcomes. Also, many of the patients in the ENHANCE study already received statin therapy before the study. Therefore, they already decreased many of their risk factors, which caused unreliable results.
The decision to discontinue or switch your cholesterol therapy from Vytorin or Zetia to another cholesterol lowering agent should be discussed with your physician. Both medications are still considered safe and represent two effective treatments to lower bad cholesterol. Results of further studies are needed to determine whether or not Zetia or Vytorin are beneficial in decreasing the risk of having cardiovascular events such as heart attacks or strokes.
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