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Nexlizet

bempedoic acid / ezetimibe
Used for High Cholesterol
Used for High Cholesterol

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.

Last reviewed on July 8, 2024
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What is Nexlizet (bempedoic acid / ezetimibe)?

What is Nexlizet (bempedoic acid / ezetimibe) used for?

How Nexlizet (bempedoic acid / ezetimibe) works

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.

Are you looking for information on Nexletol (bempedoic acid) or Nexplanon (etonogestrel) instead?

Drug Facts

Common BrandsNexlizet
Drug ClassACL inhibitor / Cholesterol absorption inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Nexlizet (bempedoic acid / ezetimibe)?

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

Other Side Effects

Source: DailyMed

More on Nexlizet (bempedoic acid / ezetimibe) side effects

The following 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):

pros-and-cons

Pros and cons of Nexlizet (bempedoic acid / ezetimibe)

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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

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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

pharmacist-tips

Pharmacist tips for Nexlizet (bempedoic acid / ezetimibe)

pharmacist
  • 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.

            • 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.

                faqs

                Frequently asked questions about Nexlizet (bempedoic acid / ezetimibe)

                How well does Nexlizet (bempedoic acid / ezetimibe) work?
                A study showed that Nexlizet (bempedoic acid / ezetimibe) lowered "bad" cholesterol (LDL-C) by almost 40% in adults who took the medication with a statin for 3 months. A separate study found that bempedoic acid, one of the ingredients of Nexlizet, lowered the risk for heart attack by almost 30%. This same study also found that bempedoic acid lowered the need for a procedure that opens blocked arteries to help blood flow to the heart (e.g., stent) by almost 20%. Talk to your primary care provider or cardiologist if you have more questions about how well Nexlizet (bempedoic acid / ezetimibe) works.
                How long does it take Nexlizet (bempedoic acid / ezetimibe) to start working?
                It's not exactly clear when Nexlizet (bempedoic acid / ezetimibe) starts to work. But a study showed that it took about a month to get to the maximum cholesterol-lowering effect with treatment. Your prescriber will schedule a blood test to check the level of different kinds of cholesterol and fats within 2 to 3 months of starting the medication. This will help you and your prescriber see how well Nexlizet (bempedoic acid / ezetimibe) is working for you.
                What's the difference between Nexlizet and Nexletol?
                Both Nexlizet and Nexletol contain bempedoic acid. But Nexlizet is a combination medication that also contains ezetimibe (Zetia), a different cholesterol medication that helps lower cholesterol levels further. Your prescriber might prefer that you start Nexlizet over Nexletol if you need multiple medications that work together to lower your cholesterol levels, in addition to following a nutritious diet.
                Is Nexlizet (bempedoic acid / ezetimibe) a statin?
                No, Nexlizet (bempedoic acid / ezetimibe) isn't a statin. Nexlizet contains an ATP-citrate lyase (ACL) inhibitor called bempedoic acid and a cholesterol absorption inhibitor called ezetimibe. Statins, ACL inhibitors, and cholesterol absorption inhibitors help lower "bad" cholesterol (LDL-C) in different ways. Your primary care provider or cardiologist might recommend that you take Nexlizet (bempedoic acid / ezetimibe) and a statin together if your cholesterol levels are still high after taking only one of these medications.
                Does Nexlizet (bempedoic acid / ezetimibe) cause weight gain?
                Weight gain wasn't a reported side effect of Nexlizet (bempedoic acid / ezetimibe) during clinical studies. Contact your primary care provider if you notice unexpected changes in your weight while you're taking Nexlizet (bempedoic acid / ezetimibe). Continuing to follow a heart-healthy diet and get regular exercise can also help with weight management.
                Does Nexlizet (bempedoic acid / ezetimibe) cause hair loss?
                Hair loss wasn't a side effect that people who took Nexlizet (bempedoic acid / ezetimibe) reported during clinical studies. Contact your healthcare team if you notice hair loss while you're taking Nexlizet (bempedoic acid / ezetimibe). They can help you figure out possible causes for your hair loss.
                Is Nexlizet (bempedoic acid / ezetimibe) safe during pregnancy?
                It's recommended to avoid taking Nexlizet (bempedoic acid / ezetimibe) during pregnancy unless the benefits are greater than the risks. Neither bempedoic acid nor ezetimibe, the ingredients in Nexlizet, have been studied during pregnancy, so it's not known how safe they are for you and your baby. Speak with your primary care provider about the risks and benefits of taking Nexlizet (bempedoic acid / ezetimibe) or other cholesterol medications if you're pregnant or thinking of getting pregnant. How your cholesterol levels are managed will partly depend on how high your cholesterol levels are. Tell your prescriber if you become pregnant while you're taking Nexlizet (bempedoic acid / ezetimibe). Report your pregnancy to the manufacturer (Esperion Therapeutics) at 1-833-377-7633 so they can follow your health and your baby's health after exposure to the medication during pregnancy.
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                What are the risks and warnings for Nexlizet (bempedoic acid / ezetimibe)?

                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-warning

                High uric acid levels

                • 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-warning

                  Tendon rupture or injury

                  • 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

                    Nexlizet (bempedoic acid / ezetimibe) dosage forms

                    The average cost for 30 tablets of 180mg/10mg of Nexlizet (bempedoic acid / ezetimibe) is $10.00 with a free GoodRx coupon. This is 98.08% off the average retail price of $520.82.
                    tablet
                    Tablet
                    DosageQuantityPrice as low asPrice per unit
                    180mg/10mg30 tablets$10.00$0.33

                    Typical dosing for Nexlizet (bempedoic acid / ezetimibe)

                    Each tablet contains 180 mg of bempedoic acid and 10 mg of ezetimibe.

                    The typical dose is 1 tablet by mouth once per day.

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                    How much does Nexlizet (bempedoic acid / ezetimibe) cost?

                    To access savings, use a GoodRx coupon and pay just a fraction of the retail price.View prices & coupons
                    contraindications-icon

                    Nexlizet (bempedoic acid / ezetimibe) contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Nexlizet (bempedoic acid / ezetimibe) will not be safe for you to take.
                    alternatives

                    What are alternatives to Nexlizet (bempedoic acid / ezetimibe)?

                    There are a number of medications that your doctor can prescribe in place of Nexlizet (bempedoic acid / ezetimibe). Compare a few possible alternatives below.
                    Nexlizet (bempedoic acid / ezetimibe)
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                    $389.94 Lowest GoodRx priceView Prices

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                    References

                    Best studies we found

                    Ballantyne, C. M., et al. (2020). Bempedoic acid plus ezetimibe fixed-dose combination in patients with hypercholesterolemia and high CVD risk treated with maximally tolerated statin therapy. European Journal of Preventive Cardiology.

                    Centers for Disease Control and Prevention. (2024). About familial hypercholesterolemia.

                    Chandramahanti, S., et al. (2024). Bempedoic acid. StatPearls.

                    View All References (8)

                    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.

                    MedlinePlus. (2022). Uric acid test.

                    MedlinePlus. (2023). Uric acid - blood.

                    National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Gallstones.

                    National Lipid Association. (n.d.). Lipid treatment in conception, pregnancy, and lactation.

                    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.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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