2-minute questionnaire
Tell us your current lipids, statin history, and target. We also review your other medications, because simvastatin has interactions your physician needs to check.
InstalabEzetimibe-Simvastatin · 10mg/10mg · generic Vytorin®
Two cholesterol medicines. One daily pill.
Ezetimibe-simvastatin (generic Vytorin®) blocks the cholesterol you absorb and the cholesterol your liver makes, cutting LDL by about 45% at the starting dose. One-time $49 online visit, no subscription. Pay your pharmacy directly for the medication.
2-in-1Complementary mechanisms
10/10mgOnce daily in the evening
~45%Avg LDL reduction at 10/10mg
Ezetimibe 10mg / simvastatin 10mg · once daily · evening
Licensed US physician review
12,000+ patients treated
Available in all 50 states
Sent to your pharmacy
How it works
From questionnaire to first dose.
A 2-minute questionnaire, a $49 online visit, and your prescription sent to the pharmacy you choose. The visit is a physician review of your answers: no appointments, no calls, no subscription.
$49 online visit
A licensed physician reviews your health history and medication list and determines whether the combination is appropriate for your lipid profile, usually within 1 business day.
Sent to your pharmacy
If approved, we send the prescription to your preferred pharmacy. You pay the pharmacy directly, usually a few dollars a month for the generic.
Lipid recheck at 4 to 12 weeks
Most of the LDL drop lands within the first two to four weeks. Recheck your lipids to confirm your response and decide whether 10/10mg is enough.
Pricing
What you'll actually pay.
Two line items: a one-time online visit and the medication itself, dispensed by your pharmacy. No subscription, no membership.
Online Visit
One-time physician review of your health history, with follow-up support included
$49one-time
Ezetimibe-Simvastatin 10mg/10mg
Generic, dispensed by your pharmacy
Cash price$6–14/monthTypical pharmacy cash price
With insurance$0–15/monthTypical copay, if covered
The online visit is a one-time fee, not a subscription. It covers a physician review of your health history and, if the physician determines treatment is appropriate, a prescription with refills for up to one year, sent to the pharmacy you choose. If no prescription is issued, the $49 fee is refunded. You pay the pharmacy directly for the medication. Renewing after a year takes a new online visit; dose changes require Instalab+, which never charges visit fees.
Need more than 10/10mg?
Step up to 10/20mg, 10/40mg, or 10/80mg with physician oversight.
If your LDL or ApoB is still above target on the starting dose, the next step is more simvastatin: 10/20mg lowers LDL about 52% and 10/40mg about 55%. Instalab+ includes the physician consults and lab follow-up that higher statin doses require.
The 10/80mg dose lowers LDL about 60% and, per the FDA label, is reserved for patients already established on it long term. If that is you, your physician can continue it inside Instalab+.
Same tablet, same evening routine. Your physician adjusts the dose based on your labs, tolerance, and the rest of your medication list.
Instalab+ also covers online visits, so dose changes and renewals never cost extra.
Explore Instalab+ →Doses available
10/10mg is where most people should start.
The starting dose already delivers about 45% LDL reduction, more than doubling what the same simvastatin dose does alone. For most people starting combination therapy, that is enough to hit target.
If your labs eventually call for more, Instalab+ includes the physician oversight that higher simvastatin doses require.
10/10 mg Available to everyone
Starting dose · ~45% avg LDL reduction · gentlest simvastatin exposure
$49 online visit
Statin muscle side effects are dose-dependent, and simvastatin's drug interactions matter more at higher doses. We don't sell the higher doses self-serve. That care belongs inside Instalab+ with physician follow-up. Per the FDA label, the 10/80mg dose is reserved for patients already taking it long term without muscle problems; we never start anyone on it.
About the medication
A simple evening routine, backed by data.
One tablet, once a day in the evening. Most patients see the bulk of the LDL reduction within two to four weeks.
- Take once daily in the eveningYour liver makes most of its cholesterol overnight, which is when simvastatin works best. With or without food.
- One pill instead of twoThe same two medicines are often prescribed as separate pills. The fixed combination gives you both in a single tablet and a single copay.
- Your medication list mattersSimvastatin interacts with certain antibiotics, antifungals, and heart medications. Your physician reviews everything you take before prescribing, and your pharmacist screens again at the counter.
- Recheck lipids at 4 to 12 weeksA follow-up lab confirms your response and tells you whether the starting dose is enough.
Why the combination
Your body gets cholesterol from two sources. This blocks both.
Cholesterol in your blood comes from what your intestine absorbs and what your liver manufactures. A statin alone only addresses production, and your gut can compensate by absorbing more. Ezetimibe-simvastatin closes both doors at once: ezetimibe blocks the NPC1L1 transporter in the small intestine while simvastatin inhibits the liver enzyme HMG-CoA reductase. That is why 10/10mg lowers LDL by about 45% when simvastatin 10mg alone typically manages about 30%.
- More LDL reduction than doubling a statinDoubling any statin dose adds roughly 6% more LDL reduction. Adding ezetimibe adds substantially more at the same statin dose, without the extra statin exposure that drives muscle side effects.
- Outcome evidence for the combinationIMPROVE-IT tested ezetimibe added to simvastatin 40mg (the 10/40 dose) in 18,144 patients after a heart attack or unstable angina, and found modestly fewer cardiovascular events than simvastatin alone. It was the first trial to show that adding a non-statin to statin therapy further reduces events.
- One pill, one routineCombination tablets simplify the daily routine and often mean one copay instead of two. Adherence is the quiet driver of real-world cholesterol results.
The IMPROVE-IT trial
Published in NEJM in 2015, IMPROVE-IT followed 18,144 post-heart-attack patients for about six years on the 10/40 dose: ezetimibe 10mg plus simvastatin 40mg versus simvastatin 40mg alone. The combination reached a lower LDL (median 54 vs 70 mg/dL) and had modestly fewer heart attacks and ischemic strokes, about 2% absolute and 6% relative, with no reduction in mortality and the clearest benefit in higher-risk patients. It validated the principle that lower LDL is better. Note the outcome data come from the 10/40 dose in patients with recent heart events, not the 10/10 starting dose sold on this page.
18,144
Post-ACS patients, on the 10/40 dose
54 vs 70
Median LDL, combo vs statin alone (mg/dL)
~6%
Relative CV event reduction (~2% absolute)
Same simvastatin dose. Very different LDL drop.
| Dose | Combination | Simvastatin alone |
|---|---|---|
10/10 mg this page | ~45% | ~28–33% |
10/20 mg Instalab+ | ~52% | ~34–38% |
10/40 mg Instalab+ | ~55% | ~41% |
10/80 mg Instalab+ | ~60% | ~49% |
What to expect
What the combination can look like in practice.
Three illustrative patient scenarios, six to ten weeks in.
16892LDL mg/dL8 weeks on 10/10mg
“Simvastatin alone got me partway there. Switching to the combination pill dropped another 40 points without changing anything else about my day.”
17596LDL mg/dL10 weeks on 10/10mg
“I was juggling two separate cholesterol pills. One tablet in the evening is easier to remember, and my numbers are the best they have been in years.”
15888LDL mg/dL6 weeks on 10/10mg
“My doctor and I wanted a big LDL drop without a high statin dose. The combination got me under 90 at the lowest simvastatin strength.”
Ezetimibe-simvastatin is a prescription medicine. Important safety information applies. Common side effects include headache, muscle aches, and diarrhea. It has meaningful drug interactions your physician will review.
Common Questions
Everything people ask before starting.
Ready when you are
Block both cholesterol sources with one pill.
Answer the questionnaire. A physician reviews your case, and if ezetimibe-simvastatin is appropriate, your prescription goes out.
No commitment to treatment.