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Assessment of Effectiveness and Safety of Rosuvastatin and Ezetimibe Combination in Patients with dyslipidemia

BASIC DETAILS

Patient code (Do not write name here) *

Date *

Diagnosis : Dyslipidemia

Patient's Age (years) *

Gender *

Male Female

Weight (in Kg) *

Obesity (BMI) *

Underweight (<18.5 kg/m²) Normal BMI (18.5-22.9 kg/m²) Over weight (23.0 -24.9 kg/m²) Obese (>25 kg/m²)

Active Smoker *

Yes No

Alcohol *

Yes No

Tobacco use *

Yes No

Family history of dyslipidemia *

Yes No

Dose of Rosuvastatin + Ezetimibe used *

Rosuvastatin + Ezetimibe (10/10 mg) Rosuvastatin + Ezetimibe (20/10 mg)

Examinations and investigations *

Adverse events *

Yes No

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