Nexletol vs. Nexlizet for High Cholesterol: Important Differences and Potential Risks.

Nexletol

(bempedoic acid)

Nexlizet

(bempedoic acid / ezetimibe)

Summary for Nexletol

Prescription only

Nexletol (bempedoic acid) is a brand-name medication that treats adults with high cholesterol, including those with a genetic condition called familial hypercholesterolemia. It also helps lower the risk of heart attack and the need for a procedure that opens blocked arteries to help blood flow to the heart in adults at risk for heart disease who aren't taking statins. Nexletol (bempedoic acid) is an ATP-citrate lyase (ACL) inhibitor that lowers LDL-C (low-density lipoprotein cholesterol). Nexletol (bempedoic acid) is a tablet that's taken by mouth once per day. Side effects include having high uric acid levels and muscle spasms.

Indications for Nexletol

Treatment of high cholesterol
Treatment of heterozygous familial hypercholesterolemia (genetic condition that causes high cholesterol)
Lower the risk of heart attack and the need for a heart procedure that opens blocked arteries to help blood flow to the heart (e.g., stent placement) in adults at risk for heart disease

Pros and Cons for Nexletol

Pros

Taken by mouth once per day
Can take by itself, with a statin, or with other cholesterol-lowering medications
Lowers LDL-C (bad cholesterol) by an average of almost 20% after 3 months of taking Nexletol (bempedoic acid) with a statin
Can take if you have mild-to-moderate kidney or liver problems

Cons

Only available as a tablet that can't be crushed
Can raise uric acid levels, which can be a cause of gout
Hasn't been studied in children, so it's not known how safe or how well the medication is for them
No lower-cost generic available; brand name only

Common Side Effects for Nexletol

High uric acid levels (16%)
Kidney problems (11%)
Anemia (low red blood cell count; 5%)
High liver enzyme levels (4%)
Muscle spasms (4%)

Warnings for Nexletol

High uric acid levels
Tendon rupture or injury

Summary for Nexlizet

Prescription only

Nexlizet is a brand-name combination medication that treats adults with high cholesterol, including those with a genetic condition called familial hypercholesterolemia. For adults at risk for heart disease who aren't taking statins, Nexlizet can help lower the risk of heart attack and the need for a procedure to open blocked arteries to help blood flow to the heart (e.g., stent placement). Nexlizet contains bempedoic acid (an ATP-citrate lyase inhibitor) and ezetimibe (a cholesterol absorption inhibitor), which both lower cholesterol. Nexlizet is a tablet that's taken once per day, by itself or with other cholesterol medications. Side effects include high uric acid levels and anemia.

Indications for Nexlizet

Treatment of high cholesterol
Treatment of heterozygous familial hypercholesterolemia (genetic condition that causes high cholesterol)
Lower the risk of heart attack and the need for a heart procedure that opens blocked arteries to help blood flow to the heart (e.g., stent placement) in adults at risk for heart disease

Pros and Cons for Nexlizet

Pros

Taken by mouth once per day
Can take by itself, with a statin, or with other cholesterol-lowering medications
Lowers LDL-C ("bad" cholesterol) by almost 40% after 3 months of taking Nexlizet (bempedoic acid / ezetimibe) with a statin
More convenient to take a single pill with two medications in it

Cons

Can raise uric acid levels, which can be a cause of gout
Not recommended while pregnant or breastfeeding because it's not known how safe the medication is in these situations
Hasn't been studied in children
No lower-cost generic available; brand name only