WHAT IS ATOZET?AtoZet contains two different medicines. One is Ezetrol (ezetimibe) and the other is atorvastatin (atorvastatin calcium trihydrate).

WHAT IS IT USED FOR?AtoZet helps to lower cholesterol and triglyceride levels. It is used in people whose cholesterol and triglyceride levels are too high and when diet alone cannot lower these levels adequately.

HOW TO TAKE ATOZETTake one AtoZet tablet once a day, whole, with a full glass of water. It is recommended that it is taken at the same time each day. Take AtoZet only when prescribed by your doctor. Follow all directions given to you by your doctor or pharmacist carefully. It can be taken with or without food.

WHAT TO DO IF YOU MISS A DOSEIf it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking your tablet as you would normally. Do not take a double dose.

HOW YOUR HEART WORKS AND WHAT CAUSESHEART DISEASEA healthy heart is essential for a healthy life. It beats over 100,000 times each day. It supplies oxygen to every muscle and organs in your body through a network of veins and arteries. Many risk factors contribute to your risk of heart disease such as your age, gender and ethnicity. These risk factors cannot be changed. Some other risk factors such as smoking, high blood pressure and high cholesterol are linked to diet and lifestyle, which can be impacted by a change in habits.

WHAT ARE CHOLESTEROL AND TRIGLYCERIDESAND WHY ARE THEY IMPORTANT?Cholesterol and triglycerides are both types of fat found in the blood that increase the risk of heart disease. Cholesterol is made by the liver and can also be ingested through food. Your cholesterol can be increased by a diet rich in saturated fats. It is essential to have some cholesterol in the body in order to produce hormones and vitamin D, but too much can cause heart disease. Over time, our arteries can become blocked by cholesterol, which can cause a heart attack or stroke.

THERE ARE TWO MAIN TYPES OF CHOLESTEROL IN YOUR BLOOD:

• HDL OR ‘GOOD’ CHOLESTEROL which helps clear the blood vessels

• LDL OR ‘BAD’ CHOLESTEROL which can block the blood vessels

Dietary cholesterol (cholesterol in food) has a small effect on ‘bad’ cholesterol but saturated fat in food can cause an increase in ‘bad’ cholesterol.

Understanding and managing your cholesterol

For patients prescribed AtoZet

A SURVEY IN 2011-12 FOUND THAT MORE THAN ONE-THIRD OF ALL AUSTRALIANS HAD HIGH TOTAL CHOLESTEROL.

‘Good’ cholesterol ‘Bad’ cholesterolvs.

HDL-C ‘good’ cholesterol

LDL-C ‘bad’ cholesterol

helps reduce cholesterol build-up and protect against heart disease.

can add to the build-up of cholesterol and plaque in your arteries and increase your risk of heart disease.

You have been given this brochure because your doctor has prescribed AtoZet for you. The leaflet does not take the place of speaking to your doctor or pharmacist; for further information about your condition or treatment please consult your doctor or pharmacist.

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DIET AND LIFESTYLE – TIPS FOR MANAGEMENTAND PREVENTION Simple changes in diet and lifestyle can help lower your ‘bad’ cholesterol levels and increase your ‘good’ cholesterol levels. Research shows that if you lower your cholesterol levels you will help reduce your risk of heart disease.

LIFESTYLE TIPS • Achieve and maintain a healthy weight.• Be active for 30 minutes on most days. Choose an

enjoyable activity of moderate intensity such as brisk walking and set realistic goals.

• Make time to relax and breathe deeply to control stress• Avoid smoking and second hand smoke.

EATING TIPS • Enjoy a wide variety of nutritious foods every day.• Use less salt and choose ‘no added salt’ products.• Replace salt with herbs and spices to flavour your food.• Limit food and drinks with added sugar especially

soft drinks and energy drinks.• Choose water as your main drink everyday.• Enjoy home cooked food more often, limiting your

fast food intake. • Listen to your body. Eat when you are hungry. Stop

When you are full.

Please insert your cholesterol levels:

Target levels in people at risk of heart

disease*(mmol/L)

Target levels in people with existing heart

disease(mmol/L)Date mmol/L

LDL (‘bad’ cholesterol) < 2.0 < 1.8^

HDL (‘good’ cholesterol) ≥ 1.0 > 1.0Triglycerides < 2.0Non-HDL cholesterol < 2.5Total Cholesterol < 4.0

Your Priorities*

Dietary or lifestyle factor

Advice

Eat a balance of vegetables, fruits, wholegrain cereals, lean meat, poultry, fish, eggs, nuts and seeds, legumes and beans, and low-fat dairy products.

Limit foods containing saturated and trans fats.

In people without coronary heart disease, limit your salt intake to < 6 g/day (approximately 2300 mg sodium). In people with existing coronary heart disease, limit your salt intake to ≤ 4 g/day (approximately 1550 mg sodium).Limit your alcohol intake to ≤ 2 standard drinks per day.At least 30 minutes moderate intensity physical activity on most or preferably every day of the week.Maintain a healthy weight. Ideal weight for most people should be BMI < 25 kg/m2 and waist circumference < 94 cm in men or < 80 cm in women.Stop smoking. Speak to your doctor about ways to help you stop smoking.

^This target is for high-risk patients who have had a coronary event*Please talk to your doctor if you are at risk of heart disease

*As advised by your doctorAdapted from NVDPA/CSANZ guidelines

Understanding and managing your cholesterol

HEALTHY EATING - TO HELP LOWER CHOLESTEROLFor a healthier heart, and to help lower cholesterol levels, try making some of the following changes to your diet:

• Eat Less saturated fat Saturated fats are found in fatty meats, cakes, pies, biscuits, fried & takeaway food, full cream dairy products and coconut products. Eating too much can raise your cholesterol levels. Replace foods high in saturated fat for those containing unsaturated fats.

• Choose polyunsaturated and monounsaturated fats and oils. These unsaturated or good fats can help lower cholesterol. Choose these fats instead of saturated fats. They are found in sunflower oil, olive oil, canola oil, polyunsaturated margarine, oily fish, avocado & nuts.

• Include omega-3 fats in your diet three times per week. Omega-3 fats are heart protective. Good sources include oily fish (e.g. salmon, tuna, sardines) & nuts.

• Increase your soluble fibre intake. Soluble fibre binds to cholesterol and helps to remove excess cholesterol from the body, lowering cholesterol levels.Foods high in soluble fibre include fruits, vegetables, legumes (e.g. baked beans and lentils) and rolled oats.

A WORD ON EGGSEggs are a good source of protein, vitamins and minerals and can be enjoyed as part of a healthy diet, even when you are trying to lower your cholesterol. Eggs contain healthy polyunsaturated fat and only small amounts of saturated fat. The dietary cholesterol level in eggs has only a small impact on LDL (bad) cholesterol.

WHAT ARE PLANT STEROLS?Plant sterols (or phytosterols) naturally occur in all plants. They are found in vegetable oils, nuts, legumes, grains and cereals. Plant sterols compete with cholesterol for absorption in the small intestine, which can stop cholesterol from being absorbed.

If you have high blood cholesterol, it is recommended that you consume 2 TO 3 GRAMS OF PLANT STEROLS* EACH DAY. In Australia, margarine spreads, breakfast cereals, low-fat yoghurt and low-fat milk are enriched with plant sterols (check packaging to choose the brands with added plant sterols). It is recommended that you consume 2-3 serves per day of these foods (along with at least one daily serve of fruit or vegetable high in beta-carotene).

*Individuals with sitosterolaemia should restrict their intake of plant sterols.

INCLUDING PLANT STEROLS DAILY IN YOUR DIET HAS BEEN SHOWN TO LOWER LDL CHOLESTEROL BY UP TO 10%.

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MEAL PLANSSUGGESTED HEALTHY SHOPPING LIST ITEMS

PANTRY• No added salt canned

food including legumes, lentils, chickpeas, four bean mix

• diced tomatoes• baked beans• canned fish• pasta• rice• noodles

• rolled oats• wholegrain crackers• herbs and spices• vegetable oil• olive oil• balsamic vinegar• nuts• dried fruit• tinned fruit• wholemeal plain flour

FRESHA range of seasonal fruit and vegetables. You can use this list as a guide: • onion • leek• garlic• ginger• greens (silver beet,

spinach, lettuces)• beans• broccoli• cauliflower• potato• pumpkin

• chillies• capsicum• mushrooms• carrots• tomatoes• apples• bananas• citrus fruits• fresh herbs• wholegrain bread or

wraps

CHILLEDLow-fat dairy products such as:• cheese• milk • yoghurt (or alternatives)

• lean meat • oily fish• eggs

FREEZER• Frozen vegetables

(beans, corn, peas, stir fry mix, broccoli, carrots)

• berries • fish • red and white meat • wholegrain bread

SAMPLE DAILY MEAL PLAN FOR A HEALTHY HEART

Breakfast• 1 Serve (1/2 cup) Overnight Oats

with reduced fat milk

Morning tea • 1 small apple• 1 coffee (200ml) with reduced fat milk

Lunch • 1 serve (2 cups) Baked Pumpkin & Chicken salad

Afternoon tea • 30g unsalted nuts

Evening meal• 1 serve (200g) Salmon, Dill & Potato

Pie• ½ cup broccoli

Evening snack • 100g reduced fat yoghurt

BREAKFAST OVERNIGHT OATS (SERVES 1)

INGREDIENTS • 1 Mason jar or a jar with a lid• 1/2 cup traditional oats• 1/2 cup low fat Greek yoghurt• 2/3 cup low fat milk or milk alternative e.g.

almond milk OPTIONAL EXTRAS• 1 tablespoon of chia seeds• 1 teaspoon of cinnamon or• nutmeg• 2-3 drops of vanilla essence INSTRUCTIONS1. Add the oats to the bottom of the jar, next the milk,

then the Greek yoghurt. Add your choice of optional extras.

2. Stir, replace the lid and refrigerate overnight.3. Serve cold or warm. Top with fresh fruit such as

chopped banana or berries as preferred.

Meal plans to help manage your cholesterol

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References:1. AtoZet Consumer Medicine Information, January 2015. http://secure.healthlinks.net.au/content/msd/cmi.cfm?product=mkcatofd 2. National Heart Foundation of Australia 2007 (Report by Vos T and Begg S, Centre for Burden of Disease and Cost effectiveness, University of Queensland School of Population Health). The burden of cardiovascular disease in Australia for the year 2003. (P.20) 3. National Health and Medical Research Council Australian Dietary Guidelines 2013. Available from:https://www.nhmrc.gov.au/_files_nhmrc/file/your_health/healthy/nutrition/n55a_australian_dietary_guidelines_summary_131014_1.pdf (P.7-28) Accessed 21 March 2017. 4. Australian Government Department of Health 2014. Australia’s Physical Activity and Sedentary Behaviour Guidelines 2014. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines/$File/Guideline%20Evidence%20Summary.PDF (P.3-4) Accessed 21 March 2017. 5. National Health and Medical Research Council Australian Dietary Guidelines to Reduce Risks from Drinking Alcohol 2009. Available from: https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ds10-alcohol.pdf (Guideline 1: P.2) Accessed 21 March 2017. 6. Heart Foundation 2007. Policy Paper: Tobacco and Cardiovascular Disease. 7. Australian Bureau of Statistics. Australian Health Survey 2011/12. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4812278BC4B8FE1ECA257BBB001217A4?opendocument (under Total Cholesterol) Accessed 21 March 2017. 8. Zhang X, Patel A, Horibe H, Wu Z, Barzi F, Rodgers A, MacMahon S, Woodward M and Asia Pacific Cohort Studies Collaboration 2003. Cholesterol, coronary heart disease and stroke in the Asia Pacific region, International Journal of Epidemiology 32 (P566 -568) Available from: http://ije.oxfordjournals.org/content/32/4/563.full.pdf+html Accessed 21 March 2017. 9. Heart Foundation 2009. Q&A: Dietary fats, dietary cholesterol and heart health. (P. 9) Available from: https://www.heartfoundation.org.au/images/uploads/publications/Dietary-Fats-QA.pdf Accessed 4 April 2017. 10. Heart Foundation 2009. Position Statement: Phytosterol/stanol enriched foods 2007 (Updated). Available from: <https://www.heartfoundation.org.au/images/uploads/publications/Dietary-fats-position-statement.pdf> (P.2, 4, 9) Accessed 4 April 2017. 11. Heart Foundation 2009. National Heart Foundation of Australia, Position statement on the relationships between carbohydrates, dietary fibre, glycaemic index/glycaemic load and cardiovascular disease. Available from: https://www.heartfoundation.org.au/images/uploads/publications/Carbohydrates-dietary-fibre-QA-Profesionals.pdf (P.11) Accessed 21 March 2017.

Copyright © 2017 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, New Jersey, U.S.A. All rights reserved. Merck Sharp & Dohme (Australia) Pty Limited. Level 1 – Building A, 26 Talavera Road, Macquarie Park NSW 2113. CARD-1210901-0000. First issued March 2017. Bloe Agency MSD12820. Brochure developed by: The Good Nutrition Co. and MSD Australia

LUNCHPUMPKIN AND CHICKEN SALAD (SERVES 2)

INGREDIENTS • 200g chicken breast fillet (skin removed)• 1 tablespoon olive oil• 3 tablespoons balsamic vinegar• 1 cup (150g) butternut pumpkin, peeled and cut into

2cm pieces• 1 teaspoon mixed dried herbs• 2 cups (150g) spinach & rocket leaves mixed• 10 cherry tomatoes, halved• 1 small tin (125g) four bean mix, rinsed• 1/2 red onion, finely sliced (optional) INSTRUCTIONS1. Pre-heat oven to 200°C (fan forced).2. Spray a frying pan with olive oil and lightly brown

chicken for 2-3 minutes on each side. Add 2 tablespoons of balsamic vinegar to pan and cook for an extra minute, turning chicken until coated. Place chicken breast and pumpkin cubes on a large baking tray lined with baking paper. Season with dried herbs as preferred. Bake for 20 minutes or until chicken is cooked through and pumpkin is tender. Slice chicken into strips.

3. Place leaves, beans, tomato and onion in a large bowl and toss. Divide salad mix between two serving bowls and add pumpkin and chicken to each.

4. Dress with remaining vinegar and olive oil. Serve warm or cold.

DINNERSALMON, DILL AND POTATO PIE (SERVES 6)

INGREDIENTS • 400g skinless, boneless salmon• 200g white boneless fish fillets• 1 carrot, peeled and thinly sliced• 1 leek, chopped• 2 1/4 cups low fat milk• 60g polyunsaturated margarine• 1/2 cup plain flour• 1 cup frozen peas• 1 tablespoon lemon juice• 2 tablespoons chopped dill• 5 large potatoes, mashed• Broccoli and green beans INSTRUCTIONS1. Pre-heat oven to 180°C (fan forced) 2. Peel and boil potatoes.3. Place fish & vegetables in a large frying pan. Pour over

2 cups of the milk and bring to a simmer. Cook for 5 mins until fish are cooked through. Strain and keep the milk mixture, setting the fish and vegetables aside. Melt 40g margarine and stir in flour with a wooden spoon. Whisk in milk mixture. Continue whisking until sauce boils and thickens.

4. Combine fish and vegetable mixture with white sauce and add peas, lemon juice and dill.

5. Drain and mash the potato with 1/2 cup low fat milk and 20g margarine. Spoon the fish mixture into a baking dish and top with mashed potato. Bake for 15 minutes or until the potato is lightly golden. Serve with steamed greens.

Recipes to help manage your cholesterol

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