Drug Interaction Report

Ezetimibe and Fenofibric Acid: Interaction Details

Name: Ezetimibe and Fenofibric Acid Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Ezetimibe and Fenofibric Acid interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Ezetimibe

Zetia Zetia®

Fenofibric Acid

Fibricor Trilipix

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Aug 8, 2026

Editorial policy · Data sources

Interaction severity

Major

Potentially serious — often needs a change or close monitoring.

Minor

Moderate

Major

Contraindicated

How we grade severity & evidence

Severity levels

Contraindicated: These should generally not be used together.
Major: Potentially serious — often needs a change or close monitoring.
Moderate: Can be significant — usually manageable with monitoring.
Minor: Usually limited clinical impact.

Evidence grades

Established: Well documented — supported by controlled studies or strong clinical data.
Probable: Good supporting evidence, though not definitively proven.
Suspected: Some evidence suggests this interaction, but it is not well established.
Possible: Limited or conflicting evidence; the interaction may occur.
Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 29 documented Ezetimibe interactions, 23 are rated major — including this one.

Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.

Onset

delayed

Evidence

theoretical

Severity

Major

What happens

Increased ezetimibe exposure and an increased risk of cholelithiasis, myopathy and rhabdomyolysis

Interaction Deep Dive

Coadministration of ezetimibe and a fibrate may cause increased cholesterol excretion into the bile, thereby increasing the risk of cholelithiasis. In a study, total ezetimibe AUC and Cmax increased 64% and 91%, respectively, when ezetimibe was coadministered with gemfibrozil (a fibrate). With the exception of fenofibrate, coadministration of ezetimibe and a fibrate is not recommended⁴³¹. Also, coadministration of ezetimibe/simvastatin may increase risk of myopathy and rhabdomyolysis. Consider if the benefit of using fibrates concomitantly with ezetimibe/simvastatin outweighs the increased risk of myopathy and rhabdomyolysis. Monitor patients for signs and symptoms of myopathy, particularly during initiation of therapy and during upward dose titration of either drug ².

Why it happens (mechanism)

Increased cholesterol excretion into the bile

Literature reports

1 report — tap to read

a) In a study, total ezetimibe AUC and Cmax increased 64% and 91%, respectively, when ezetimibe 10 mg was coadministered with gemfibrozil 600 mg twice daily for 7 days ⁴³¹.

Common questions

Can I take Ezetimibe and Fenofibric Acid together?

Increased ezetimibe exposure and an increased risk of cholelithiasis, myopathy and rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.

How serious is the Ezetimibe and Fenofibric Acid interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

Does my dose of Ezetimibe or Fenofibric Acid need adjusting while I take them together?
What symptoms should prompt me to call you or my prescriber right away?
Does the timing of my doses matter for this combination?
Is there a safer alternative to one of these medications for me?

References (4)

Product Information: ZETIA(R) oral tablets, ezetimibe oral tablets. Organon LLC (per FDA), Jersey City, NJ, 2023. DailyMed
Product Information: VYTORIN(R) oral tablets, ezetimibe simvastatin oral tablets. Organon LLC (per FDA), Jersey City, NJ, 2024. DailyMed
Product Information: Ezetimibe oral tablets, ezetimibe oral tablets. Aurobindo Pharma USA Inc (per DailyMed), East Windsor, NJ, 2020. DailyMed
Product Information: NEXLIZET® oral tablets, bempedoic acid ezetimibe oral tablets. Esperion Therapeutics Inc (per FDA), Ann Arbor, MI, 2026. DailyMed

Was this write-up helpful?

Ezetimibe

Keep reading about Ezetimibe

All Ezetimibe interactions (29) Ezetimibe drug information

Also serious with: Danazol Cyclosporine Ophthalmic Cyclosporine Cyclosporine Injection

Fenofibric Acid

Keep reading about Fenofibric Acid

All Fenofibric Acid interactions (16)

Also serious with: Lovastatin Cyclosporine Ophthalmic Colestipol Cyclosporine Injection

Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Ezetimibe + Activated Charcoal Coffee Charcoal European Mandrake Flaxseed Oil Glucomannan Guar Gum Gum Arabic Slippery Elm + 10 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

Check another combination

Our instant two-drug interaction checker is almost here.

Coming soon

The instant two-drug checker is on its way.

In the meantime, browse the directory below to look up any drug and see its documented interactions.

Still have questions about this combination?

Every question gets a real answer from a licensed pharmacist — free, and usually within a day.

Ask the pharmacist

A message from HelloPharmacist

About our interaction database: depth, not breadth

HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.