Does Zetia Cause Muscle Pain?
Key Takeaways
- Yes, Zetia (ezetimibe) can cause muscle pain, but it’s not the most common side effect when Zetia is taken alone.
- Muscle symptoms are reported more often when Zetia is combined with statins (like atorvastatin, simvastatin, or rosuvastatin).
- Rarely, muscle pain can signal myopathy or rhabdomyolysis, which need urgent medical attention, especially if you also have dark urine, fever, or severe weakness.
- If you develop new muscle pain, a healthcare provider may recommend blood tests (such as creatine kinase and liver enzymes) and review possible drug interactions.
What is Zetia (ezetimibe) and why is it prescribed?
Zetia is the brand name for ezetimibe, a prescription medicine used to help lower cholesterol, especially LDL cholesterol (often called “bad cholesterol”). It’s used for high cholesterol levels (hyperlipidemia) and can be used alone or together with a statin drug when additional LDL lowering is needed.
Zetia works differently from statins. Statins mainly reduce how much cholesterol your liver makes, while ezetimibe reduces the absorption of cholesterol in the intestine.
For some people, especially those with familial hypercholesterolemia or those who can’t tolerate higher statin doses, Zetia is another treatment option that helps reduce cardiovascular risk and protect against heart disease.
Does Zetia cause muscle pain?
Yes, muscle pain, muscle aches, tenderness, weakness, or muscle cramps can occur with Zetia, but it is not common when taken by itself.
Zetia alone vs. Zetia with statins
- Zetia alone: Muscle pain can happen, but it’s not typically one of the top common side effects.
- Zetia + statins: Muscle pain (myalgia) is reported more often when Zetia is used alongside statins such as atorvastatin (Lipitor), simvastatin (Zocor), or rosuvastatin (Crestor). This is important because statins themselves can cause muscle symptoms, and combination therapy can increase the chance that muscle issues show up.
When muscle pain is mild vs. when you need to seek medical attention
Most muscle symptoms reported with cholesterol-lowering therapy are not dangerous. But there are a few conditions you should know:
Myalgia
This is the everyday term for muscle aches or soreness. It can be uncomfortable, but it is often not linked to severe muscle damage.
Myopathy
Myopathy is more concerning. It generally refers to muscle symptoms (pain, tenderness, weakness) linked with evidence of muscle injury.
Rhabdomyolysis (rare but serious)
Rhabdomyolysis is a severe form of muscle injury where muscle breakdown can lead to kidney complications. It’s rare, but it’s the reason healthcare professionals take muscle complaints seriously, especially when certain risk factors are present.
Seek medical attention urgently if you have muscle pain plus:
- Dark urine (tea-colored or cola-colored)
- Severe muscle weakness (not just soreness)
- Fever, chills, or feeling very ill
- Muscle pain that rapidly worsens
- Decreased urination
These can be warning signs of serious side effects, and you should get medical attention promptly.
Risk factors that may increase muscle problems
If you develop muscle pain while taking Zetia, your healthcare provider will often review risk factors such as:
- Using Zetia with statins (especially at higher statin doses)
- Taking fibrates (cholesterol drugs used to lower triglycerides), such as fenofibrate or gemfibrozil
- History of liver disease or liver problems
- Kidney issues (can worsen outcomes if rhabdomyolysis occurs)
- Older age, frailty, or multiple medications
- Use of certain supplements or over-the-counter products that can interact with prescription meds
- Heavy alcohol use (can increase risk of liver problems)
Other common and serious side effects of Zetia
Common side effects
People taking Zetia may notice:
Shop Medications
- Upper respiratory tract infections or common cold symptoms like a sore throat
- Diarrhea
- Abdominal pain
- Joint pain (arthralgia)
- Fatigue
Serious side effects
- Allergic reaction: rash, hives, swelling, trouble breathing
- Liver enzyme elevations (sometimes detected on routine blood tests)
- Potential liver damage (rare, but possible—watch for yellowing skin/eyes, severe fatigue, dark urine)
- Severe muscle injury: myopathy or rhabdomyolysis
If you notice a skin rash or other unusual symptoms, don’t ignore them; contact a healthcare provider.
What tests might your provider order?
If you report muscle pain, your healthcare provider may consider:
- Creatine kinase (CK) to look for muscle injury
- Liver enzymes (ALT/AST), because lipid medications can affect the liver
- Cholesterol labs to monitor LDL cholesterol response
These blood tests help determine whether muscle pain is a tolerable side effect or a sign of something that needs treatment changes.
Drug interactions to know
Zetia is often used with other cholesterol medications, and that’s when interaction questions come up. Be sure to tell your prescriber about all medications, including OTC and supplements, especially if you take:
- Simvastatin, atorvastatin, or rosuvastatin
- Fenofibrate or other fibrates (and ask specifically about gemfibrozil)
- Immune medications such as cyclosporine
- Any new supplements marketed for cholesterol, weight, or bodybuilding
Your healthcare professional can help review your full list for interaction risk.
Breastfeeding and Zetia
If you are breastfeeding, ask your healthcare provider for medical advice before using Zetia. Guidance may differ based on your cholesterol level, overall heart disease risk, and alternative treatment options.
What to do if you think Zetia is causing muscle pain
Here’s a practical approach:
- Don’t dismiss it. Report new muscle symptoms to your provider immediately.
- Do not stop medications abruptly without talking to your provider, especially if you have significant hyperlipidemia or cardiovascular risk.
- They may suggest a temporary pause on Zetia or the statin, switch statins, reduce the statin dose, or try Zetia alone if appropriate.
- Ask if blood tests are needed now.
Also, if you believe you’ve had an unexpected adverse effect, you can discuss reporting to MedWatch with your clinician.
FAQs
Is muscle pain more common with Zetia or statins?
Muscle symptoms are more commonly associated with statins, and they may be reported more often when Zetia is taken with a statin than when Zetia is taken alone.
Can Zetia cause joint pain too?
Yes, joint pain has been reported and can occur with Zetia.
What’s the difference between myalgia and rhabdomyolysis?
Myalgia is muscle soreness or aches. Rhabdomyolysis is a rare, severe muscle breakdown that can cause complications and requires immediate medical attention.
Does Zetia cause weight gain?
Weight gain is not a common Zetia side effect. If weight changes happen, it’s worth reviewing diet, activity, and other medications with your healthcare provider.
Can Zetia affect blood pressure?
Zetia does not typically affect your blood pressure directly. However, lifestyle changes, such as a healthy diet and regular exercise, are recommended while taking it. These changes can positively affect your cholesterol and blood pressure.
Sources
- Zetia (ezetimibe) tablets, for oral use [prescribing information]. FDA. Last updated 7/2023. Accessed Dec. 10, 2025.