Nexlizet (Bempedoic Acid and Ezetimibe) – Oral

What Is Nexlizet?

Nexlizet (bempedoic acid and ezetimibe) is a prescription oral tablet that contains both bempedoic acid and ezetimibe. This medication is approved by the Food and Drug Administration (FDA) to be combined with diet and statin therapy for the treatment of familial hypercholesterolemia (genetic high cholesterol) or certain heart diseases that require additional lowering of bad cholesterol.

Bempedoic acid acts as an adenosine triphosphate-citrate lyase (ACL) inhibitor that lowers “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol, by decreasing the amount of cholesterol your liver makes.

Throughout the body, there are specific proteins that speed up reactions that happen inside our bodies known as enzymes.

These enzymes can help speed up important reactions that would normally take hours, allowing them to occur in minutes instead.

ACL is one of many enzymes required to make cholesterol. By inhibiting ACL, the amount of cholesterol produced in the liver decreases. With this decrease in cholesterol, the liver cells increase the uptake of bad cholesterol from the blood, thus lowering LDL.

Ezetimibe acts on Niemann-Pick C1-Like 1 (NPC1L1), which is a unique transporter responsible for taking up cholesterol. By inhibiting NPC1L1, the amount of cholesterol absorbed from the small intestine is decreased, leading to a decrease in the delivery of cholesterol to the liver.

Nexlizet is available for oral consumption in film-coated tablet form.

Drug Facts

Generic Name: Bempedoic acid and ezetimibe

Brand Name(s): Nexlizet 

Drug Availability: Prescription 

Administration Route: Oral

Therapeutic Classification: Antihyperlipidemic

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Bempedoic acid and ezetimibe

Dosage Form(s): Film-coated tablet

What Is Nexlizet Used For?

The FDA approved Nexlizet along with diet and statins for the treatment of adults with the following conditions:

  • Genetic high cholesterol (heterozygous familial hypercholesterolemia)
  • Established heart disease for people who require additional lowering of LDL

How to Take Nexlizet

Nexlizet usually is taken once a day with or without food. It is important to swallow the tablet whole. Do not chew the medication.

Nexlizet should be taken either at least two hours before or four hours after bile acid sequestrants, including Colestid (colestipol), Welchol (colesevelam), and Prevalite (cholestyramine).

Storage

Nexlizet should be stored in a cool, dry place. In general, medications should be kept away from places that are very hot like above your stove, or in places that are very humid like your bathroom.

These environments can impact how well the medications work. Keep this medication away from children and pets to avoid accidental consumption.

No specific travel requirements are provided by the Transportation Security Administration for Nexlizet.

When you want to refill this medication, request a refill from your pharmacy before you run out of Nexlizet.

How Long Does Nexlizet Take to Work?

After starting Nexlizet, it may take up to a week for a noticeable reduction in cholesterol levels and about 12 weeks to reach maximum effect. Recheck your cholesterol eight to 12 weeks after starting Nexlizet.

What Are the Side Effects of Nexlizet?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Nexlizet include:

Severe Side Effects

Potential serious side effects associated with Nexlizet use include:

You should call 911 if your symptoms feel life-threatening, or if you think you are experiencing a medical emergency.

Report Side Effects

Nexlizet may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Nexlizet Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For heterozygous familial hypercholesterolemia (HeFH) and patients with heart disease who need additional lowering of their bad cholesterol (LDL) levels:
      • Adults—One tablet once a day together with a statin medicine. Each tablet contains 180 milligrams (mg) bempedoic acid and 10 mg ezetimibe.
      • Children—Use and dose must be determined by your doctor.

Modifications

For adults with normal-functioning kidneys, no dose modifications are necessary. However, this medication is not recommended for adults with moderate to severe liver problems.

It is not known if Nexlizet is safe and effective in children under 18 years of age. In pregnant people, it is recommended to discontinue Nexlizet unless the benefits of therapy outweigh the potential risks to the fetus.

Breastfeeding is not recommended with Nexlizet. The use of Nexlizet in adults 65 and older have been determined to be safe and effective, although greater sensitivity of the drug may occur in older individuals.

Missed Dose

If you miss a dose of Nexlizet, you should take it as soon as you remember. If the time when you remember happens to be close to the next scheduled dose, you should take just the scheduled dose and not take the one that was missed. You should not take more than one dose at a time.

Overdose: What Happens If I Take Too Much Nexlizet?

What Happens If I Overdose on Nexlizet?

If you think you or someone else may have overdosed on Nexlizet, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking interferon alfa-2b, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Ezetimibe may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing or swallowing, or any swelling of your hands, face, or mouth after using this medicine.

This medicine may increase the uric acid levels in the blood (hyperuricemia), which can lead to gout. This can occur within 4 weeks of using this medicine. Check with your doctor right away if you have joint pain, stiffness, or swelling, lower back, side, or stomach pain, or swelling of the feet or lower legs.

Tendon problems, including swelling, inflammation, or rupture can occur in the shoulder (rotator cuff), upper arm (biceps tendon), or Achilles tendon at the back of the ankle, within days or months after starting treatment with bempedoic acid and ezetimibe combination. If you hear or feel a snap or pop, have bruising right after an injury, or are unable to move or put weight in an affected tendon area, check with your doctor right away. Avoid using and exercising the affected area.

Using this medicine together with simvastatin or pravastatin may increase your risk of developing muscle pain or weakness. Talk to your doctor if you have any concerns.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Nexlizet?

This medication should be used cautiously if you have a history of gout. The use of Nexlizet has been shown to increase uric acid levels, which can cause a gout flare-up. If you are on Nexlizet, monitor your uric acid if you are experiencing any signs and symptoms of high uric acid levels.

People who are 60 or older, people taking corticosteroids, people taking antibiotics such as fluoroquinolones Cipro (ciprofloxacin), or Levaquin (levofloxacin), and those with renal (kidney) failure have an increased risk of experiencing tendon ruptures.

This medication should be avoided if you have a history of tendon disorders or tendon ruptures. It’s also important to remember that Nexlizet is discouraged in people with a known hypersensitivity to ezetimibe tablets.

What Other Medications Interact With Nexlizet?

Nexlizet should be separated when taking bile acid sequestrants, another class of drugs that also lowers bad cholesterol, and includes Colestid (colestipol), Welchol (colesevelam), and Questran (cholestyramine).

Most of the medications that interact with Nexlizet are common drugs taken for high cholesterol.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter (OTC) medicines, vitamins, and herbal supplements.

Especially tell your healthcare provider if you take or plan to take the following cholesterol-lowering medications:

Taking Nexlizet with simvastatin or pravastatin may increase the likelihood of muscle pain or muscle weakness. The use of Nexlizet with fibrates such as fenofibrate can also increase the likelihood of muscle pain or muscle weakness.

When using Nexlizet with bile acid sequestrants, take your Nexlizet either two hours before or four hours after you take your bile acid sequestrants as it may decrease how good your Nexlizet works.

This is not a complete list of all the drugs that may interact with Nexlizet. Always keep an up-to-date list of all the medicines you take and share this information with your healthcare provider and pharmacist any time there are changes.

What Medications Are Similar?

Nexlizet is a medication that has been approved by the FDA for genetic high cholesterol or certain heart diseases that require additional lowering of bad cholesterol.

Examples of similar drugs that lower cholesterol includes:

This is a list of drugs that are commonly prescribed for high cholesterol. It is not a list of drugs recommended to take with Nexlizet.

You should ask your pharmacist or your healthcare provider if you have any questions or concerns.

Frequently Asked Questions

  • How does Nexlizet work?

    Nexlizet contains both bempedoic acid and ezetimibe and creates a dual action for lowering your cholesterol. Bempedoic acid stops an important enzyme needed to make cholesterol while ezetimibe makes your small intestine absorb less cholesterol than normal.

  • How long does it take for Nexlizet to work?

    Nexlizet may take at least a week to have an effect on your cholesterol, with its maximum effect taking up to 12 weeks.

  • What else should I do to manage my high cholesterol?

    A healthy diet is very important in controlling high cholesterol. You may be advised to follow a Dietary approaches to stop hypertension (DASH) diet which will generally consist of low daily amounts of salt, and a larger amount of leafy green vegetables. Exercise is also crucial. Experts recommend 30 minutes of moderate-intensity exercise per day.

  • What are the side effects of Nexlizet?

    Common side effects of Nexlizet include flu-like symptoms, back pain, stomach pain, muscle spasms, diarrhea, constipation, and drowsiness.

How Can I Stay Healthy While Taking Nexlizet?

In order to stay healthy while taking Nexlizet, it is important to take Nexlizet as directed by your healthcare provider. Nexlizet should be taken daily to control your cholesterol levels.

Along with regular use of Nexlizet, aim to live a healthy lifestyle by maintaining a healthy diet, exercising regularly, and taking your statins and other cholesterol medications as directed.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. National Human Genome Research Institute. Enzyme.

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