Nexletol
Bempedoic acid
Used together with diet and statin medicine to lower bad cholesterol (LDL) in people with cardiovascular disease or inherited high cholesterol.
Antihyperlipidemic
Tablet
By mouth
Nexletol is used to lower LDL cholesterol in people who:
Have an inherited condition called heterozygous familial hypercholesterolemia (HeFH) that causes very high levels of LDL
Have cardiovascular disease, are on a statin, and need to lower LDL more
Many people with high cholesterol are able to lower LDL cholesterol levels with a combination of diet and statin medications. But people with some forms of inherited high cholesterol or with cardiovascular disease may need a second medication to lower LDL more.
Nexletol comes in one dose and is prescribed together with a statin.
A cholesterol-lowering diet is recommended together with Nexletol and statins.
Most people tolerate Nexletol without side effects.
Tendon rupture is a risk for a small group of people taking Nexletol. Sharing your health history and all medications you take with your healthcare provider is important in determining your risk.
Tablet
180 mg
Starting dose: 180 mg once a da
Standard dose: 180 mg once a day
Maximum dose: 180 mg once a day
Nexletol
30 tablets bottle
Nexletol is taken as a tablet once a day. Do not use more than directed.
Nexletol may be taken with or without food.
Store the medicine in a closed container at room temperature away from heat, moisture, and direct light.
Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
This medicine is not right for everyone. Do not use it if you have had an allergic reaction to bempedoic acid.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
Tell your doctor if you:
Are pregnant or breastfeeding
Have kidney or liver disease
Have had cardiovascular conditions like heart attack or stroke
Have a history of gout
Have a history of muscle or tendon problems
This medicine may cause:
Increased uric acid levels in the blood, which can lead to gout
Tendon problems, including swelling, inflammation, or rupture
Increased risk for muscle pain or weakness, especially when taken together with simvastatin or pravastatin
Keep all medicine out of the reach of children. Never share your medicine with anyone.
Some medicines can affect how bempedoic acid works. Tell your doctor about all medications you take, including prescription and over-the-counter medicines, vitamins, herbs, and supplements. Nexletol may especially interact with:
Cholesterol medications pravastatin or simvastatin
Fluoroquinolone antibiotics such as ciprofloxacin and levofloxacin
Steroid medications like prednisone
Serious side effects may include:
Tendon rupture
Hearing or feeling a snap or pop in a tendon
Bruising right after an injury
Being unable to move or put weight on an affected tendon area, including the shoulder, upper arm, or back of the ankle
Tendon rupture on this medication is more common in people over 60, who have kidney disease, have a history of tendon problems, or are taking fluoroquinolone antibiotics or steroids.
Serious allergic reaction
Itching or hives
Swelling in your face or hands
Swelling or tingling in your mouth or throat
Chest tightness or trouble breathing
Side effects that are less serious but more common include:
Upper respiratory infections and bronchitis
Back pain or pain in the arms and legs
Muscle spasms
Increase in uric acid levels
Gout (warm, painful, swollen joints from increased uric acid)
Abdominal pain or upset
Anemia (low blood count)
Increase in liver enzymes
Get emergency medical treatment for symptoms of an allergic reaction. Also, get help right away for any signs or symptoms of a tendon rupture. Contact your healthcare provider for severe muscle pain, abdominal pain, fatigue, or symptoms of gout.
Even common or mild side effects may become worse or interfere with day-to-day activities. Tell your doctor about side effects that won’t go away or are getting worse.
Nexletol, Esperion Therapeutics (2022)
Nexletol (healthcare professionals page), Esperion Therapeutics (2024)
Nexletol - bempedoic acid tablet, film coated, National Library of Medicine DailyMed (2023)
Anne Jacobson, MD, MPH, is a board-certified family physician, writer, editor, teacher, and consultant. She is a graduate of University of Wisconsin School of Medicine and Public Health, and trained at West Suburban Family Medicine in Oak Park, Illinois. She later completed a fellowship in community medicine at PCC Community Wellness and a master's in Public Health at the University of Illinois-Chicago. She lives with her family near Chicago.
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