Ezetimibe (Zetia): how it works, status and trials

Approved (generic)PillLowering LDL cholesterol

Ezetimibe blocks cholesterol absorption in the gut. Less cholesterol reaches the liver, so liver cells build more LDL receptors to pull LDL out of the blood.

In technical terms: Blocks cholesterol uptake from the gut, so less cholesterol reaches the liver and the liver makes more LDL receptors.

The highlighted badge marks where Ezetimibe (Zetia) acts. Open the full map or compare every therapy.

At a glance

Acts on: NPC1L1 · intestine
How it is given: Oral · daily
What the main trial found: LDL-C ≈ −18% alone, ≈ −25% added to a statin; MACE ↓ (IMPROVE-IT)
Status (curated October 25, 2026): Approved (generic)

Where it fits in the body

Cholesterol synthesis and absorption

When the liver has less cholesterol, whether because synthesis is blocked (statins, bempedoic acid) or less arrives from the gut (ezetimibe, bile acid sequestrants), SREBP-2 switches on the LDL-receptor gene and the liver pulls more LDL out of the blood. SREBP-2 also raises PCSK9, which is one reason PCSK9 inhibitors add well to statins.

See it on the interactive map

Evidence

IMPROVE-IT (PubMed 26039521)

Trials in our database

SEAS (2008): No significant benefit
SHARP (2011): Benefit
IMPROVE-IT (2015): Benefit
EWTOPIA 75 (2019): Benefit
RACING (2022): No significant benefit

Common questions

▸How does Ezetimibe (Zetia) work?

Ezetimibe blocks cholesterol absorption in the gut. Less cholesterol reaches the liver, so liver cells build more LDL receptors to pull LDL out of the blood. In technical terms: Blocks cholesterol uptake from the gut, so less cholesterol reaches the liver and the liver makes more LDL receptors. It acts on NPC1L1 · intestine.

▸How much does Ezetimibe (Zetia) lower cholesterol or other lipids?

LDL-C ≈ −18% alone, ≈ −25% added to a statin; MACE ↓ (IMPROVE-IT). Individual results differ, and a clinician can say what to expect for one person.

▸Is Ezetimibe (Zetia) approved, and what is the status?

Approved (generic) (curated October 25, 2026).

▸How is Ezetimibe (Zetia) taken?

Oral · daily.

Ezetimibe (Zetia): Uses, Side Effects and Cost

Related therapies

Statins: Approved (generic)
Bempedoic acid (Nexletol, Nexlizet): Approved 2020
Bile acid sequestrants (colesevelam): Approved (generic)
Evolocumab (Repatha) and alirocumab (Praluent): Approved 2015

Not medical advice. Mechanism and status text curated October 25, 2026; registry data refreshed November 1, 2026. Registries can lag company announcements. Effects are placebo-adjusted results from the main published trial, not head-to-head comparisons. Investigational agents are available only in clinical trials. lipid.site is not a healthcare provider. Talk to your clinician before starting or stopping any treatment. If you have chest pain or signs of a stroke, call 911.