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.
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
Nexlizet (bempedoic acid / ezetimibe) is a combination of two medications that work together to lower cholesterol levels.
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. Bempedoic acid works by blocking ACL, which stops the process of making LDL-C (low-density lipoprotein cholesterol), also known as "bad cholesterol."
Ezetimibe is a cholesterol absorption inhibitor. It blocks the amount of cholesterol that gets absorbed into your body from the gut.
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 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
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
Mark your calendar with your appointments to see your primary care provider or cardiologist and to get any blood work done. Your prescriber will order blood tests during treatment to check your cholesterol levels and see how well the medication is helping you. Your prescriber might change your Nexlizet (bempedoic acid / ezetimibe) dose based on your lab results.
It's fine to take Nexlizet (bempedoic acid / ezetimibe) at any time, with or without food. Be sure to take it at the same time every day. Making it a part of your daily routine can help you to remember to take your medication.
Swallow the tablets whole. Don't crush, chew, or split the tablets. Let your prescriber know if you're having trouble swallowing the tablets. They might switch you to a different cholesterol-lowering medication.
It's important that you follow a balanced and nutritious diet that's low in fat and get regular exercise while you're taking Nexlizet (bempedoic acid / ezetimibe). This will help you get the most benefit out of your treatment. Talk with your prescriber about how to plan your meals and what kind of exercise is appropriate for you.
Limit or avoid alcohol while you're taking Nexlizet (bempedoic acid / ezetimibe). This medication and alcohol can both raise your risk for liver problems. Drinking a lot of alcohol can make your cholesterol go up. Speak with your prescriber about your drinking habits if it isn't possible for you to completely avoid alcohol.
If you're taking a bile acid sequestrant like cholestyramine (Prevalite) or colesevelam (Welchol), take Nexlizet (bempedoic acid / ezetimibe) at least 2 hours before or 4 hours after the bile acid sequestrant. Taking them together will cause your body to absorb less Nexlizet (bempedoic acid / ezetimibe), so it won't work as well.
You shouldn't take more than 20 mg of simvastatin (Zocor) or 40 mg of pravastatin (Pravachol) per day with Nexlizet (bempedoic acid / ezetimibe). The levels of these statins can go up in the body, which can put you at risk for muscle pain from the statin. Tell your prescriber if you feel muscle pain while you're taking Nexlizet (bempedoic acid / ezetimibe) with a statin.
Tell your prescriber if you take a fibrate or cyclosporine (Sandimmune, Neoral) before you start Nexlizet (bempedoic acid / ezetimibe). Taking these medications together with Nexlizet (bempedoic acid / ezetimibe) can affect medication levels, which can lead to side effects. Your prescriber might need to adjust your treatment plan and follow up with you more often.
Nexlizet (bempedoic acid / ezetimibe) 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
Nexlizet (bempedoic acid / ezetimibe) can raise your uric acid levels in the blood. This can start to happen within the first month of taking Nexlizet (bempedoic acid / ezetimibe). High uric acid levels can lead to symptoms of gout, such as pain, redness, and tenderness in your joints. Contact your prescriber if you experience any symptoms of gout. You'll probably need to get your uric acid levels checked through a blood test. If your uric acid levels are high, you might have to start taking medications that help bring your uric acid levels down.
Risk factors: Age older than 60 years | Taking corticosteroids or certain antibiotics with Nexlizet (bempedoic acid / ezetimibe) | Kidney failure | History of tendon problems
Although very rare, it's possible for Nexlizet (bempedoic acid / ezetimibe) 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 bempedoic acid alone (one of the ingredients of Nexlizet). 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 because you might have to stop taking Nexlizet (bempedoic acid / ezetimibe).
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
180mg/10mg | 30 tablets | $10.00 | $0.33 |
Each tablet contains 180 mg of bempedoic acid and 10 mg of ezetimibe.
The typical dose is 1 tablet by mouth once per day.
Allergy to ezetimibe or bempedoic acid
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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Chandramahanti, S., et al. (2024). Bempedoic acid. StatPearls.
Esperion Therapeutics, Inc. (2024). Nexlizet- bempedoic acid and ezetimibe tablet, film coated [package insert]. DailyMed.
McGowan, M. P., et al. (2019). Diagnosis and treatment of heterozygous familial hypercholesterolemia. Journal of the American Heart Association.
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Nissen, S. E., et al. (2023). Bempedoic acid and cardiovascular outcomes in statin-intolerant patients. The New England Journal of Medicine.
Sizar, O., et al. (2023). Ezetimibe. StatPearls.
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