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.
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
Nexletol (bempedoic acid) is an ATP-citrate lyase (ACL) inhibitor. ACL is a protein in your body that's involved in making cholesterol in your liver. Nexletol (bempedoic acid) works by blocking ACL. This helps stop your body from making LDL-C (low-density lipoprotein cholesterol), also known as "bad cholesterol." As a result, the medication helps lower LDL-C levels in your blood.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
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
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
It can take a few months for your cholesterol levels to drop after you start treatment with Nexletol (bempedoic acid). Follow up with your prescriber when instructed to get a blood test done to check your lipid panel (the levels of different kinds of cholesterol and fats in your blood). This will help you and your prescriber see how well Nexletol (bempedoic acid) is working for you.
Take Nexletol (bempedoic acid) with or without food. You can try taking it with food to help with any upset stomach you might have from the medication.
Swallow the Nexletol (bempedoic acid) tablets whole. Let your prescriber know if you're having trouble swallowing them. Discuss with your prescriber whether there's a different cholesterol-lowering medication that might be easier for you to take.
Nexletol (bempedoic acid) works best if you take it every day, follow a balanced and nutritious heart-healthy diet, and get regular exercise. Speak with your prescriber about resources for meal planning and exercises that are appropriate for you.
Limit or avoid alcohol while you're taking Nexletol (bempedoic acid). Both alcohol and Nexletol (bempedoic acid) can raise the risk for liver problems. In addition, drinking a lot of alcohol can make your cholesterol go up. Speak with your prescriber about your drinking habits and how to safely take Nexletol (bempedoic acid).
It's not recommended to take more than 20 mg of simvastatin (Zocor) or 40 mg of pravastatin (Pravachol) per day with Nexletol (bempedoic acid). The levels of these particular statins can rise in the body when you take them with Nexletol (bempedoic acid). This can raise your risk for statin-related muscle pain. Let your prescriber know if you feel muscle pain if you're taking Nexletol (bempedoic acid) with a statin.
Nexletol (bempedoic acid) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of gout
Nexletol (bempedoic acid) can raise your uric acid levels in the blood. This usually starts to happen within the first month of taking Nexletol (bempedoic acid). High uric acid levels can lead to symptoms of gout, like pain, redness, and tenderness in your joints. Contact your prescriber if you have any gout symptoms. Your prescriber might need to check your uric acid levels through blood work. Depending on your lab results, your prescriber might recommend that you start taking medications that help lower your uric acid levels.
Risk factors: Age older than 60 years | Taking corticosteroids or certain antibiotics with Nexletol (bempedoic acid) | Kidney failure | History of tendon problems
Although very rare, it's possible for Nexletol (bempedoic acid) to raise the risk for injury or rupture in your tendons. In clinical trials, tendon rupture happened in fewer than 1% of people who took Nexletol (bempedoic acid). These injuries happened in the shoulder, biceps, or Achilles heel. And they happened within the first weeks to months of treatment.
The risk for tendon injuries might be higher in people older than 60 years old, people taking corticosteroids or certain antibiotics like ciprofloxacin (Cipro), people with kidney failure, and people with a history of tendon problems. Don't exercise or do anything that could worsen your injury if you have any pain or swelling in a joint or if you have difficulty moving a joint. Contact your prescriber right away if you have symptoms of tendon problems because you might have to stop taking Nexletol (bempedoic acid).
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
180mg | 30 tablets | $10.00 | $0.33 |
The typical dose is 180 mg by mouth once per day.
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
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
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Esperion Therapeutics, Inc. (2024). NEXLETOL- bempedoic acid tablet, film coated [package insert]. DailyMed.
Leiter, L. A., et al. (2022). Bempedoic acid in patients with type 2 diabetes mellitus, prediabetes, and normoglycaemia: A post hoc analysis of efficacy and glycaemic control using pooled data from phase 3 clinical trials. Diabetes, Obesity and Metabolism.
McGowan, M. P., et al. (2019). Diagnosis and treatment of heterozygous familial hypercholesterolemia. Journal of the American Heart Association.
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Ray, K. K., et al. (2019). Safety and efficacy of bempedoic acid to reduce LDL cholesterol. The New England Journal of Medicine.
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