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May 1, 2023



9 Things You Should Know Before Taking Nexletol

  • Nexletol (bempedoic acid) is a non-statin cholesterol-lowering drug that's approved by the FDA in Februray 2020
  • Nexletol is approved as an adjunct therapy with diet or other cholesterol medication.
  • Nexletol is less effective than statins but maybe an alternative for people with statin intolerance.

What is Nexletol?

Nexletol is a medication used to treat high cholesterol. It is a newer drug that was approved by the FDA in February 2020. It contains bempedoic acid, which is a type of drug that works differently from statins, another medication used to lower cholesterol.

Both Nexletol and statins work to lower the production of LDL-C (also known as "bad" cholesterol) in the liver, but they do so by targeting different enzymes. Statins work by blocking an enzyme called HMG-CoA reductase, while Nexletol works by blocking another enzyme called ATP citrate lyase (ACL), which is why it is called an ACL inhibitor.

How does Nexletol work?

Making cholesterol in the body involves several steps, and enzymes are involved in each step. The process starts with a molecule called acetyl-CoA, which gets converted into another molecule called HMG-CoA, and then into mevalonate, which finally becomes cholesterol.

Nexletol blocks the action of an enzyme called ACL. This enzyme helps convert a molecule called citrate to acetyl-CoA, which is the starting molecule in the cholesterol-making process. By blocking ACL, Nexletol interrupts the early stages of cholesterol synthesis. Statins, on the other hand, work by blocking an enzyme that helps convert acetyl-CoA into HMG-CoA, which is a critical step in the cholesterol-making process.

How Nexletol and statins work

In order to reduce LDL levels, Nexletol is taken in conjunction with a healthy diet and may be taken with other lipid-lowering drugs. Exercise, weight loss if overweight and smoking cessation are some lifestyle changes that may help this drug function better, in addition to eating a healthy diet, including a low-cholesterol or a low-fat diet.

In clinical trials, Nexletol has been shown to lower LDL-C levels by up to 18-28% when taken alone, and by up to 38% when taken in combination with a statin. Compared to statins, Nexletol may be less effective at lowering LDL-C levels.

However, Nexletol may be a good option for patients who cannot tolerate or are not responding well to statin therapy, or for patients who require additional LDL-C lowering despite being on a statin.

What is Nexletol used for?

Individuals who are at least 18 years old with the following conditions can be treated with Nexletol in conjunction with diet and other lipid-lowering medications:

  • Individuals that require further reduction of LDL-C levels including those with preexisting heart disease.
  • Heterozygous Familial Hypercholesterolemia (HeFH)—a medical condition that causes high levels of LDL cholesterol.

How is Nexletol administered?

Nexletol is a 180 mg tablet that can be taken by mouth (swallowed whole, not crushed or chewed), once daily, with or without a meal.

Keep in mind that you might not get the full benefits of this medication for up to 12 weeks.

Nexletol should be taken exactly as prescribed by your doctor. If you're unsure about how to take this medication, ask your doctor or pharmacist for advice.

What are the side effects of Nexletol?

Although Nexletol is safe and effective for many individuals, it does cause some negative effects, including the following:

  • Anemia (decreased levels of red blood cells)
  • Increased levels of liver enzymes
  • Muscle spasms
  • Back, shoulder, leg, and/or arm pain and/or joint pain
  • Abdominal pain
  • Respiratory infections, including the common cold or flu-like symptoms
Serious side effects
  • A ruptured or torn tendon
    Tendons are strong tissue strands that attach muscles to bones. Your arm, shoulder, and back of the ankle tendons, among others, might experience discomfort, swelling, rupture, and inflammation as a result of tendon complications.
  • Increased levels of uric acid (hyperuricemia). Gout may result from high blood uric acid levels.
    • This might occur 4 weeks after you start taking Nexletol and could persist all the way through your therapy.
    • While you're on Nexletol, your doctor may check the levels of uric acid in your blood.
    • Signs of high levels of uric acid include includes significant pain, redness, and/or tenderness in your joints
  • Allergic reaction (symptoms may include skin rash, itching, or swelling that may occur under your skin, such as your lips, hands, feet, tongue, mouth, and/or throat, and difficulty breathing).

If you’re experiencing any of the serious side effects listed above, immediately call your doctor or 911 if it's an emergency, and stop taking this medication.

Can Nexletol interact with anything?

Drug interactions might alter how particular medications function or raise the possibility of significant negative side effects.

Your doctor may prescribe Ezetimibe (brand: Zetia) together with Nexletol. This cholesterol- lowering drug functions differently from another drug class of medications known as statins and Nexletol. It reduces the amount of cholesterol that your intestines absorb following a meal.

Additionally, Nexletol is also frequently used with statins, which are medications that are commonly used to decrease cholesterol.

However, if you're also taking Nexletol, your physician may adjust the dosage for 2 statins called Simvastatin (brand: Zocor) and Pravastatin (brand: Pravachol). Inform your doctor if you take these medications before using Nexletol.

Inform your physician or pharmacist about all of your current medicines, including prescription and over-the-counter (OTC), prior to using Nexletol. Include a description of any supplements, herbs, or vitamins you take.

Can I take Nexletol if I’m pregnant?

It's unknown if Nexletol is safe to take while pregnant because there haven't been any studies conducted on how this medication may or may not affect pregnant women and the developing fetus.

Immediately notify your doctor if you become pregnant while taking Nexletol. If you should take this medication while you are pregnant, you and your doctor will decide whether the benefits outweigh the risks.

It is unknown if Nexletol goes into breast milk if you are nursing. The decision to take Nexletol or breastfeed should be decided in consultation with your doctor. However, doing both is generally not advised.

What happens if I miss a dose?

Take your Nexletol as soon as you remember if you miss a dose. However, if it's almost time for your next dosage, skip it and take your next dose at the usual time. Consult your doctor or pharmacist if you miss a dosage or are unclear about when to take your next dose.

Speak With Your Doctor

Nexletol is relatively considered a safe and effective medication when taken appropriately (as prescribed by your doctor). Talk to your doctor today about using Nexletol and send your prescription to Marley Drug. Save up to 95% compared to your local pharmacy by using Marley Drug.

Marley Drug provides free nationwide shipping, allowing you to receive your medication at no additional cost straight to your door.

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