Nexlizet (bempedoic acid and ezetimibe; 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 or established atherosclerotic cardiovascular disease who require additional lowering of low-density lipoprotein cholesterol (LDL-C).

Nexlizet combines the adenosine triphosphate-citrate lyase (ACL) inhibitor, bempedoic acid, with ezetimibe, a cholesterol absorption inhibitor. Findings from a phase 3 study showed that patients treated with Nexlizet achieved greater improvements in LDL-C at Week 12 than those administered placebo (adjusted difference -38%; 95% CI: -47, -30; P <.001), ezetimibe alone (-23.2%; P <.001) or bempedoic acid alone (-17.2%; P <.001).

The recommended dosage of Nexlizet, in combination with maximally tolerated statin therapy, is 1 tablet orally once daily; 1 tablet contains bempedoic acid 180mg and ezetimibe 10mg. 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. Following initiation, lipid levels should be analyzed within 8-12 weeks. 

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Nexlizet is supplied in bottles containing 30 and 90 tablets. Additionally, Esperion recently announced the availability of Nexletol (bempedoic acid).

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