What is Nexletol: Uses, Warnings & Interactions

Medically reviewed by Anne JacobsonMD, MPH
Board-Certified Family Physician
Updated Mar 11, 2024  •  Published Dec 30, 2020
Fact Checked

Nexletol overview

BRAND NAMES:

  • Nexletol

Generic Names:

  • Bempedoic acid

Uses:

  • Used together with diet and statin medicine to lower bad cholesterol (LDL) in people with cardiovascular disease or inherited high cholesterol.

Therapeutic Classes:

  • Antihyperlipidemic

Forms:

  • Tablet

How it’s taken:

  • By mouth

What is Nexletol used for?

  • 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.

What form(s) does Nexletol come in

  • Tablet

    • 180 mg

What are common Nexletol doses?

  • Starting dose: 180 mg once a da

  • Standard dose: 180 mg once a day

  • Maximum dose: 180 mg once a day

Common Nexletol prescriptions

  • Nexletol
    30 tablets bottle

How to take Nexletol

  • 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.

What to do if you miss a dose of Nexletol

  • 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.

Nexletol contraindications

  • This medicine is not right for everyone. Do not use it if you have had an allergic reaction to bempedoic acid.

Nexletol warnings

  • 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.

Nexletol interactions

  • 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:

Nexletol side effects

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.

Sources:

Medically reviewed by Anne JacobsonMD, MPH
Board-Certified Family Physician

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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