The use of Zetia requires special attention to liver enzyme abnormalities, muscle symptoms, and drug interaction risks. During the treatment period, regular monitoring of liver function and creatine kinase is necessary to avoid combination with specific drugs, and any related adverse reactions should be promptly treated. The following provides a detailed explanation of precautions from three aspects: elevated liver enzymes, muscle pain, and drug interactions.

Monitoring of elevated liver enzymes

(1) Regular check ups: During treatment, AST/ALT levels need to be monitored, especially when combined with statins. It is recommended to undergo regular testing before and within 12 weeks after medication.

(2) Discontinuation criteria: If liver enzymes continue to rise to more than three times the upper limit of normal values, the medication should be immediately discontinued and the degree of liver function damage should be evaluated.

(3) High risk population: moderate to severe liver dysfunction should be used with caution, and patients with alcoholic liver disease should strengthen monitoring frequency.

2. Muscle pain management

(1) Symptom recognition: When experiencing unexplained muscle pain, weakness, or tenderness, be alert to the risk of rhabdomyolysis.

(2) Urgent action: Immediately test creatine kinase levels. If it exceeds 10 times the upper limit of normal or is accompanied by renal dysfunction, discontinue medication.

(3) Risk of combination therapy: When used in combination with statins or beta drugs, the incidence of muscle symptoms may increase and should be closely monitored.

3 drug interactions

(1) Prohibited combination: Combination with cyclosporine can increase the blood concentration of ezetimibe by 15 times, which is an absolutely contraindicated combination.

(2) Caution in combination: Combination with beta agonists may increase the risk of gallstones, and it is recommended to undergo gallbladder ultrasound examination every 6 months during the combination period.

(3) Dose adjustment: Combined use with warfarin may enhance anticoagulant effects, and frequent monitoring of INR values and adjustment of warfarin dose are necessary.