Nexletol™ (bempedoic acid; Esperion) is now available for use as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia (HeFH) or established atherosclerotic cardiovascular disease (ASCVD) who require additional lowering of low-density lipoprotein cholesterol (LDL-C).

Bempedoic acid is a first-in-class adenosine triphosphate-citrate lyase (ACL) inhibitor that lowers LDL-C by inhibiting cholesterol synthesis in the liver. Treatment is administered orally once daily and can be taken with or without food. Following initiation, lipid levels should be analyzed within 8 to 12 weeks.

The most common adverse reactions reported with treatment include upper respiratory tract infection, muscle spasms, hyperuricemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anemia, and elevated liver enzymes. In addition, the risk of tendon rupture or injury may be increased in bempedoic-treated patients. 

According to pharmacokinetic data, the administration of simvastatin or pravastatin with bempedoic acid may result in increased levels of the statins and related myopathy, therefore concomitant simvastatin >20mg or pravastatin >40mg should be avoided.

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Nexletol is supplied as a 180mg tablet in 30-count and 90-count bottles. A prescription savings program has been established for eligible patients.

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