If your last blood tests revealed less than desirable cholesterol numbers, your health-care provider probably discussed the link between high blood cholesterol and an increased risk of heart disease and heart attack. In 2002, Merck and Schering Plough Pharmaceuticals launched a new addition to the arsenal of cholesterol-lowering drugs: Zetia. While Zetia's effects on cholesterol have been quantified, its effects on weight are less defined.
Mechanism of Action
Zetia is an anti-lipemic and cholesterol absorption inhibitor. It reduces LDL, or "bad" cholesterol, by blocking its absorption in your small intestine. In "Nelson Textbook of Pediatrics," West Virginia University professor of pediatrics William Neal indicates that Zetia can lower total cholesterol by 20 to 30 mg/dL. Clinicians often recommend it for moderate elevations in blood cholesterol. The typical daily dosage is 10 mg for children above the age of 10 and adults alike.
Zetia & Combination Therapy
When considering Zetia's association with weight loss, it's important to distinguish its solo administration from combination therapy. Ezetimibe, the active compound in Zetia, is not known to directly cause weight loss when administered alone. However, ezetimibe is often marketed as an adjunct to other cholesterol-lowering drugs. Vytorin, for instance, contains ezetimibe and simvastatin, a member of the statin family of cholesterol-lowering drugs. Weight loss is a common side effect of statins, according to West Virginia University professor of pediatrics William A. Neal. Thus, Zetia is more likely to cause unintended weight loss when administered with statin drugs.
Zetia & Lifestyle Changes
The National Cholesterol Education Program advocates a number of therapeutic lifestyle changes for individuals with high LDL, or bad cholesterol. Helpful changes include a cholesterol-lowering diet, smoking cessation, regular physical activity and weight management. Obviously, the fact that these recommendations also apply to medicated patients can make it difficult for you to discern whether an observed weight loss results from your cholesterol medication alone or from lifestyle changes. However, controlled studies reported in a 2010 issue of the "Diabetes Care" journal suggest that adding ezetimibe to a weight management program enhances weight loss and reduces bad cholesterol by greater levels than lifestyle changes alone.
The scientific literature does not clearly document weight loss as a side effect of Zetia therapy. However, according to Medline Plus, Zetia can cause appetite loss, difficulty swallowing, an upset stomach and pain in the upper right part of the stomach. Although the above symptoms are rare, they could conceivably contribute to weight loss by reducing your food intake. More likely side effects include headaches, dizziness, diarrhea, sore throat, runny nose, sneezing and joint pain.
Clinicians, such as Professor Neal, view Zetia as a safe cholesterol-lowering medication. Side effects, he notes, seldom occur. Beyond cholesterol, however, Zetia raises controversy. Scientists argue that there is no proof that it can reduce the risk of heart attacks or heart disease like statins do. What's more, Vytorin trials have raised concerns that combining Zetia with simvastatin may increase cancer risk. According to New York-based Center for Medical Consumers associate director Maryann Napoli, this increased cancer risk is intolerable because Zetia offers only an extra 17 percent reduction in LDL cholesterol, compared to statin drugs.
- "Mosby's 2010 Nursing Drug Reference;" Linda Skidmore-Roth, R.N., M.S.N., N.P.; 2010
- "Diabetes Care;" Effect of ezetimibe on Hepatic Fat, Inflammatory Markers, and Apolipoprotein B-100 Kinetics in Insulin-Resistant Obese Subjects on a Weight Loss Diet; Dick C. Chan, Ph.D., et al.; May 2010
- "Nelson Textbook of Pediatrics, 18th Ed.;" Robert Kliegman, M.D., William Neal, M.D., et al.; 2007
- Medline Plus: Ezetimibe (Zetia)
- "Health Facts;" Vytorin and Zetia Continue to be Prescribed Despite Hints of Harms and No Proof of Benefit;; Maryann Napoli; October 2008