Nexletol
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.
What is Nexletol (bempedoic acid)?
What is Nexletol (bempedoic acid) used for?
- 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
How Nexletol (bempedoic acid) works
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.
Drug facts
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Side effects of Nexletol (bempedoic acid)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- High uric acid levels (16%)
- Kidney problems (11%)
- Anemia (low red blood cell count; 5%)
- High liver enzyme levels (4%)
- Muscle spasms (4%)
Less Common Side Effects
- Gout
- Gallstones
- Back or stomach pain
More on Nexletol (bempedoic acid) side effects
The following Nexletol (bempedoic acid) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- High uric acid level—severe pain, redness, warmth, or swelling in joints, pain or trouble passing urine, pain in the lower back or sides
- Joint, muscle, or tendon pain, swelling, or stiffness
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Diarrhea
- Muscle spasms
- Stomach pain
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Pros and cons of Nexletol (bempedoic acid)
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
Pharmacist tips for Nexletol (bempedoic acid)
- 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.
Common questions about Nexletol (bempedoic acid)
People who took Nexletol (bempedoic acid) had an almost 20% average drop in their LDL-C ("bad cholesterol") levels after about 3 months of treatment in a study comparing Nexletol (bempedoic acid) to a placebo. Keep in mind that most people in the study were also taking other cholesterol-lowering therapy, such as a statin, at the same time. Make sure to get your cholesterol tests done on time so you and your prescriber can discuss how well Nexletol (bempedoic acid) is working for you at your follow-up visits.
The effect that Nexletol (bempedoic acid) might have on triglycerides, a type of fat, isn't clear. There were mixed results from a group of studies with people who took Nexletol (bempedoic acid) with other cholesterol-lowering therapy for 3 months. One study showed that some people had slightly raised triglyceride levels and another study found that some people had slightly lower triglyceride levels at the end of the study. But overall, Nexletol (bempedoic acid) appears that it doesn't affect triglyceride levels by much. Talk with your prescriber about a treatment plan that's best for you if you have high triglyceride levels.
No, Nexletol (bempedoic acid) isn't a statin. Instead, it's an ATP-citrate lyase (ACL) inhibitor. Both ACL inhibitors and statins help lower "bad" cholesterol (LDL-C). But they work in different ways to stop your body from making cholesterol. Your primary care provider or cardiologist might recommend that you take Nexletol (bempedoic acid) and a statin together if your cholesterol levels are still high after you take one of these medications by itself.
Both Nexletol and Nexlizet contain bempedoic acid. But Nexlizet is a combination medication. In addition to bempedoic acid, Nexlizet also contains ezetimibe (Zetia), which is a different medication that works in another way to help lower cholesterol levels further. Your prescriber might prefer that you take Nexlizet if you need to take multiple medications in addition to following a heart-healthy diet to help with your cholesterol.
Nexletol (bempedoic acid) doesn't appear to cause weight gain; there weren't any reports of weight gain from people who took the medication during clinical studies. A study actually showed that some people with diabetes or prediabetes along with high cholesterol who took Nexletol (bempedoic acid) for 3 months experienced very little weight loss (less than a pound on average). Speak with your care team if you notice unexpected changes in weight during treatment with Nexletol (bempedoic acid).
Hair loss wasn't reported from people who took Nexletol (bempedoic acid) during clinical studies. Contact your healthcare team if you notice hair loss while you're taking this medication. They can help you figure out possible causes for your hair loss.
No. Nexletol (bempedoic acid) is currently available as a brand-name medication only.
It's not known whether Nexletol (bempedoic acid) is safe to take while pregnant or breastfeeding because there hasn't been enough research about this. So, it's generally recommended to avoid using Nexletol (bempedoic acid) while you're pregnant or breastfeeding unless the benefits clearly outweigh the risks. Speak with a healthcare professional to see whether this medication is right for you if you're pregnant, thinking of getting pregnant, or breastfeeding. And tell your prescriber if you become pregnant during treatment. It's recommended that your pregnancy gets reported to the manufacturer (Esperion Therapeutics) at 1-833-377-7633 so researchers can follow your health and your baby's health after exposure to the medication during pregnancy.
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Risks and warnings for Nexletol (bempedoic acid)
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.
High uric acid levels
- 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.
Tendon rupture or injury
- 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).
Nexletol (bempedoic acid) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 180mg | 30 tablets | $10.00 | $0.33 |
Typical dosage for Nexletol (bempedoic acid)
The typical dose is 180 mg by mouth once per day.
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How much does Nexletol (bempedoic acid) cost?
$10.00
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