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Nexletol
bempedoic acid
Adult Dosing .
Dosage forms: TAB: 180 mg
primary hyperlipidemia
- [180 mg PO qd]
heterozygous familial hypercholesterolemia
- [180 mg PO qd]
cardiovascular event risk reduction
- [180 mg PO qd]
renal dosing
- [see below]
- eGFR >30: no adjustment; eGFR <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: renal failure
- caution: tendon disorder hx
- caution: tendon rupture risk
- caution: gout hx
Drug Interactions .
Overview
bempedoic acid
ACL inhibitor
- OATP1B1 inhibitor, weak
- OATP1B3 inhibitor, weak
- hyperuricemic effects
Contraindicated
- grazoprevir
Avoid/Use Alternative
- atrasentan
- brincidofovir
- elagolix
- resmetirom
- zavegepant
Monitor/Modify Tx
- atogepant
- atorvastatin
- betamethasone
- budesonide
- ciprofloxacin
- cortisone
- deflazacort
- delafloxacin
- dexamethasone
- eluxadoline
- febuxostat
- fluvastatin
- hydrocortisone
- levofloxacin
- lovastatin
- methylprednisolone
- momelotinib
- moxifloxacin
- nateglinide
- ofloxacin
- pegloticase
- pitavastatin
- pravastatin
- prednisolone
- prednisone
- rasburicase
- red yeast rice
- repaglinide
- rosuvastatin
- simvastatin
- triamcinolone
Caution Advised
- bosentan
- bromocriptine
- glecaprevir
- rifampin
- voxilaprevir
Adverse Reactions .
Serious Reactions
- tendon rupture
- hypersensitivity rxn
- angioedema
Common Reactions
- URI
- muscle spasms
- hyperuricemia
- back pain
- abdominal pain
- bronchitis
- extremity pain
- renal impairment
- anemia
- leukocytes decr.
- Plt incr.
- LFTs elevated
- gout
- cholelithiasis
Safety/Monitoring .
Monitoring Parameters
uric acid
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available; no known risk of teratogenicity based on animal data at 11-12x MRHD
Pregnancy Reporting
report any suspected fetal exposure to the Esperion Therapeutics, Inc. Adverse Event reporting line at 1-833-377-7633
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: liver; CYP450: none; Info: prodrug converted to active coenzyme A (CoA) form
Excretion: urine 70%, feces 30%; Half-life: 21h
Subclass: Dyslipidemia: Adenosine Triphosphate-Citrate Lyase (ACL) Inhibitors
Mechanism of Action
inhibits adenosine triphosphate-citrate lyase (ACL), inhibiting cholesterol synthesis
Formulary .
No Formulary Selected
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