Nexletol (bempedoic acid) is a prescription drug approved to treat high cholesterol and reduce heart-related risks in certain adults. Nexletol comes as an oral tablet that you swallow.

Specifically, Nexletol is used to:

For reducing LDL cholesterol, Nexletol is used either alone or with other cholesterol-lowering medications, along with a healthy diet.

Nexletol basics

Nexletol is a brand-name medication that comes as an oral tablet that you swallow. It contains the active ingredient bempedoic acid.

A generic version of Nexletol isn’t currently available.

Like most drugs, Nexletol may cause mild or serious side effects.

Common side effects of Nexletol in the drug’s studies for hyperlipidemia treatment were:

  • upper respiratory tract infection
  • muscle spasms
  • hyperuricemia (too much uric acid in the blood)
  • back pain
  • abdominal pain or discomfort
  • bronchitis
  • pain in the arms or legs
  • anemia
  • elevated liver enzymes

Common side effects of Nexletol in studies of the drug for reduction of risks associated with cardiovascular disease were:

  • hyperuricemia (too much uric acid in the blood)
  • kidney problems
  • anemia
  • elevated liver enzymes
  • muscle spasms
  • gout
  • gallstones

These lists don’t include all possible side effects of Nexletol.

Your doctor will recommend the dosage of Nexletol that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form and strength

Nexletol comes as a tablet that you take by mouth. It comes in a strength of 180 milligrams (mg).

Recommended dosage

You’ll likely take one 180-mg Nexletol tablet per day. You can take Nexletol with or without food.

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Nexletol is known to interact with certain statins (other cholesterol-lowering drugs), specifically:

Before taking Nexletol, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, or supplements you use. Sharing this information can help you avoid potential interactions.

Whether you have health insurance or not, cost may be a factor when you’re considering Nexletol. What you’ll pay for Nexletol may depend on several things, such as your treatment plan and the pharmacy you use.

Here are things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks for price estimates of Nexletol. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.
  • Savings programs: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A manufacturer-sponsored program called Nexstep may also be available.

Learn more about saving on your prescriptions.

The following is important information to consider and discuss with your doctor or pharmacist before using Nexletol.

Pregnancy and breastfeeding

Nexletol may harm a fetus if taken during pregnancy, based on how the drug works. Your doctor will likely not prescribe Nexletol if you’re pregnant or planning to become pregnant.

Tell your doctor if you’re pregnant or considering pregnancy before starting Nexletol. They can recommend which treatments are safe for your high cholesterol during pregnancy.

If you’re exposed to Nexletol during pregnancy, tell your doctor about any side effects you experience. Your doctor could report these side effects to the Bempedoic Acid Pregnancy Surveillance Program. Bempedoic acid is Nexletol’s active ingredient. Reporting side effects through this program helps researchers better understand the drug’s risks.

Breastfeeding is not recommended with Nexletol. It isn’t known if Nexletol passes into breastmilk if taken while breastfeeding. Tell your doctor if you’re breastfeeding or considering breastfeeding before taking Nexletol. They’ll likely recommend that you do not take Nexletol.

If you’re taking simvastatin or pravastatin, your doctor may lower your statin dose when you start taking Nexletol. This lowers your risk of an interaction.

This list does not contain all types of drugs that may interact with Nexletol. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Nexletol.

Nexletol and alcohol

Nexletol and alcohol aren’t known to interact. But before starting Nexletol treatment, ask your doctor if it’s safe for you to drink alcohol.

Drinking alcohol may affect your heart health. Drinking a lot of alcohol over time can negatively affect your heart health.

Before using Nexletol, discuss your health history with your doctor. Nexletol may not be right for you if you have certain medical conditions or other factors affecting your health.

Be sure to talk with your doctor if any of the following apply to you:

  • Gout (a type of arthritis) or hyperuricemia (high uric acid level). Tell your doctor if you (or anyone in your family) have had hyperuricemia or gout. Increased uric acid levels in the blood is a possible side effect of Nexletol. This can increase your risk of gout, especially if you have a personal or family history of this condition. If you have symptoms of hyperuricemia or gout during Nexletol treatment, tell your doctor right away. If your uric acid levels rise or if you develop gout, your doctor may have you stop taking Nexletol. But you should not stop taking the drug without talking with your doctor first.
  • Allergic reaction. If you’ve had an allergic reaction to Nexletol or any of its ingredients, your doctor will likely recommend that you don’t take Nexletol. Ask your doctor what other medications are better options for you.
  • Kidney failure. If you have kidney failure, talk with your doctor about whether it’s safe for you to use Nexletol. Having kidney failure can increase your risk of a tendon rupture (tear) with Nexletol.
  • Severe liver problems. Nexletol may cause high levels of liver enzymes (a type of protein). This can be a sign that your liver isn’t functioning correctly. Be sure to talk with your doctor about whether it’s safe for you to take Nexletol if you have severe liver problems.
  • Risk factors for tendon rupture. If you’ve had a tendon rupture in the past, your doctor will likely not prescribe Nexletol. This is because tendon rupture is a possible side effect of the drug. You have a higher risk of tendon rupture if you’re ages 60 years or older, or if you have kidney failure. Your risk is also higher if you take other medications that can cause tendon rupture. These include corticosteroids and fluoroquinolones (a type of antibiotic). Be sure to tell your doctor about your medical history and all the medications you’re taking before you start Nexletol.

Here are answers to some commonly asked questions about Nexletol.

How does Nexletol work?

Nexletol is an adenosine triphosphate-citrate lyase (ACL) inhibitor. It works by inhibiting (blocking) the ACL enzyme. This is a type of protein in the liver that makes LDL cholesterol.

By blocking this enzyme, Nexletol lowers the amount of LDL cholesterol that your liver makes. This is Nexletol’s mechanism of action (how the drug works in your body).

When the liver makes less LDL cholesterol, the body produces more LDL receptors. LDL receptors are a type of protein on cells that move LDL cholesterol from your blood into your cells. This lowers the amount of cholesterol in your blood.

Talk with your doctor or pharmacist if you have questions about how Nexletol works.

What should I know about Nexletol and the alternative drug Repatha?

Nexletol and Repatha are both cholesterol-lowering medications. Repatha contains the active ingredient evolocumab. Nexletol’s active ingredient is bempedoic acid. Repatha works in a slightly different way than Nexletol.

Repatha works by blocking an enzyme called PCSK9. PCSK9 breaks down LDL receptors on liver cells, which keeps your body from removing extra cholesterol from your blood. By blocking this enzyme, Repatha allows LDL receptors to remove cholesterol from your blood, which lowers your LDL cholesterol.

Your doctor or pharmacist can provide more information about how Nexletol compares with Repatha and similar drugs.

Is Nexletol a statin?

No, Nexletol isn’t a statin.

Similar to statins, Nexletol is used to lower cholesterol. But Nexletol works in a different way than statins. It’s a type of drug called an ACL inhibitor. See “How does Nexletol work?” just above for details.

Examples of statin drugs include:

Do not take more Nexletol than your doctor prescribes. Using more than this can lead to serious side effects. There’s no information on the symptoms of overdosing on Nexletol.

What to do in case you take too much Nexletol

Call your doctor if you think you’ve taken too much Nexletol. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. However, if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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