🔬 Mechanism of Action (MOA):

Ezetimibe selectively inhibits the Niemann-Pick C1-Like 1 (NPC1L1) protein located at the brush border of the small intestine.

✅ This blocks absorption of dietary and biliary cholesterol into enterocytes (intestinal cells).

🔄 As a result:

• ↓ Cholesterol delivery to the liver

• ↑ LDL receptor expression in the liver

• ↑ Clearance of LDL from the blood

📉 Net Effect: ↓ LDL-C (by ~18–25%)

🧪 Often used with statins to enhance LDL lowering synergistically.

⚠️ Adverse Effects of Ezetimibe:

🩺 Generally well tolerated, but may cause:

📌 Clinical Note:

• 🧠 Ezetimibe is not affected by CYP450 enzymes, so fewer drug interactions than statins.

• 🛡️ Good alternative or add-on therapy for patients who cannot tolerate high-dose statins.