Ezetimibe: An Unusual Suspect in Angioedema

Area of Science:

• Pharmacology
• Clinical Medicine
• Allergy and Immunology

Background:

• Ezetimibe is a commonly prescribed cholesterol-lowering medication.
• Angioedema is a potentially serious allergic reaction characterized by swelling.
• Previous reports of Ezetimibe-associated angioedema are limited.

Observation:

• A case of new-onset angioedema in an elderly patient on long-term Ezetimibe therapy is presented.
• The patient developed facial and oral swelling hours after taking Ezetimibe.
• The patient had a history of drug-induced bradykinin reactions.

Findings:

• Ezetimibe was identified as the likely cause of angioedema.
• Treatment with corticosteroids, epinephrine, and antihistamines resolved the swelling within 48 hours.
• Normal C1 esterase inhibitor levels and negative allergy testing ruled out typical allergic mechanisms.

Implications:

• This case suggests a potential association between Ezetimibe and angioedema, distinct from bradykinin or mast cell-mediated reactions.
• Clinicians should be aware of this rare side effect and counsel patients on recognizing and reporting symptoms.
• Further research is needed to elucidate the mechanism of Ezetimibe-induced angioedema.