Clinical and pharmacological aspects of combined lipid-lowering therapy
DOI: 10.32364/2587-6821-2025-9-9-4
A.S. Dukhanin
Pirogov Russian National Research Medical University, Moscow, Russian Federation
The use of fixed combinations (FC) of statin plus ezetimibe, compared to loose combinations (LC), improves the efficacy of pharmacological therapy for hypercholesterolemia. Real-world clinical studies indicate that, among patients receiving LC of statin and ezetimibe, the risk ratio for treatment discontinuation is higher compared to those treated with FC. Numerous studies have demonstrated a strong association between high treatment adherence and a reduced incidence of major adverse cardiovascular events (MACE). Fixed combinations are pharmaceutical formulations in which a single dose contains two or more active substances, manufactured in a definite dosage form — such as a tablet or capsule. The capsule form of FC, which contains rosuvastatin and ezetimibe as separate tablets within a single capsule, offers several benefits. These include the complete exclusion of lactose as an excipient, with its substitution by mannitol; absence of restrictions for patients with galactose intolerance, lactase deficiency, or glucose-galactose malabsorption; and the omission of film coating (tablets contained within the capsule are uncoated). The natural gelatin capsule itself serves as protection against environmental factors and masks the taste, thereby eliminating the need for a film coating.
Keywords: hypercholesterolemia, statins, rosuvastatin, ezetimibe, fixed combination, treatment persistence, medication adherence.
For citation: Dukhanin A.S. Clinical and pharmacological aspects of combined lipid-lowering therapy. Russian Medical Inquiry. 2025;9(9):554–558 (in Russ.). DOI: 10.32364/2587-6821-2025-9-9-4
About the author:
Alexander S. Dukhanin — Dr. Sc. (Med.), Professor of the Department of Molecular Pharmacology and Radiobiology named after Academician P.V. Sergeev, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117513, Russian Federation; ORCID iD 0000-0003-2433-7727
Contact information: Aleksander S. Dukhanin, e-mail: das03du@mail.ru
Financial Disclosure: the author has no a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 30.06.2025.
Revised 23.07.2025.
Accepted 15.08.2025.
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