Bempedoic Acid

1 medicine

Bempedoic acid is a cholesterol-lowering tablet that carries a risk of tendon rupture, most often in the Achilles, shoulder or biceps tendon.

Nexletol

Bempedoic acid

180mg

Nexletol is a heart blood pressure medication containing Bempedoic acid, available as 180mg tablets.

from $1.57 / tablet View

Key facts

  • Bempedoic acid (sold as Nexletol, and combined with ezetimibe as Nexlizet) lowers LDL ("bad") cholesterol by blocking an enzyme the liver uses to make it.
  • It is taken once daily as a tablet, usually alongside a statin or in people who cannot tolerate a statin dose high enough to control their cholesterol.
  • It carries a risk of tendon rupture or tendon injury, most often affecting the Achilles, shoulder or biceps tendon. The risk is higher in people over 60, those taking corticosteroids, and those with kidney disease or a past tendon problem.
  • Seek urgent care for sudden tendon pain, swelling, or a snapping sensation, especially in the heel, shoulder or arm.

What bempedoic acid treats

Bempedoic acid treats high LDL cholesterol that remains elevated despite statin treatment, including familial hypercholesterolaemia, and it is used in people who cannot tolerate an effective statin dose. It is prescribed alongside diet and other cholesterol-lowering measures to reduce cardiovascular risk; it does not directly treat existing heart disease.

How bempedoic acid works

After being converted to its active form in the liver, bempedoic acid blocks ATP citrate lyase, an enzyme that acts earlier in the cholesterol-production pathway than the step statins block. This reduces the liver's own cholesterol output and increases the clearance of LDL cholesterol from the blood.

Before you take it

  • Avoid bempedoic acid if you are pregnant, planning a pregnancy, or breastfeeding, since safety has not been established.
  • Tell your prescriber about kidney disease, a past tendon problem, or if you take a corticosteroid or a fluoroquinolone antibiotic, both of which also raise tendon risk.
  • Bempedoic acid can raise blood levels of some statins, increasing the chance of muscle-related side effects, so your statin dose may need review.

Side effects

Common effects include muscle aches, raised uric acid (sometimes triggering gout pain), mild abdominal discomfort, and modest increases in liver enzymes.

Stop and seek urgent medical care for any of these:

  • Sudden tendon pain, swelling, or a snapping sensation.
  • Severe muscle pain combined with weakness or dark urine.
  • Yellowing of the skin or eyes.
  • Signs of a serious allergic reaction, such as facial swelling or difficulty breathing.

Safety essentials

  • Tendon rupture is the defining risk: rest the affected limb and get it checked urgently if you feel sudden tendon pain or swelling, particularly in the Achilles tendon, and stop the medicine until you have been assessed.
  • Periodic blood tests for uric acid and liver enzymes are recommended, especially in the first months of treatment.
  • Tell every prescriber you take bempedoic acid, since it can raise the levels of statins and other medicines cleared by the same pathway.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.