A 56-year-old white man with hypertension and a strong family history of cardiovascular disease was referred to a lipid-specialty clinic secondary to a statin intolerance (ie, myalgias) and dyslipidemia. The patient was initiated on ezetimibe 10 mg daily and experienced a supratherapeutic response. His baseline low-density lipoprotein cholesterol was reduced by 52% after 8 months of ezetimibe therapy, with no other explanation for the marked reduction. Recent studies have indicated a wide range of response to ezetimibe with different genetic variations. It is likely that this patient has a genetic variation that resulted in a hyperresponse to ezetimibe.
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