Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Nexlizet

Descriptions


Bempedoic acid and ezetimibe combination is used together with diet and other cholesterol-lowering medicines to reduce bad cholesterol (LDL) in patients with primary hyperlipidemia (high blood cholesterol), including heterozygous familial hypercholesterolemia (HeFH).

Bempedoic acid and ezetimibe combination is also used to lower the risk of heart attack and heart procedures (eg, stent placement or bypass surgery) in patients who are unable to take or are not taking a cholesterol-lowering medicine (eg, statin), who have heart disease or who are at high risk for heart disease.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of bempedoic acid and ezetimibe combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of bempedoic acid and ezetimibe combination in the elderly.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Cyclosporine
  • Danazol
  • Gemfibrozil

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Bezafibrate
  • Cholestyramine
  • Ciprofibrate
  • Clofibrate
  • Colesevelam
  • Colestipol
  • Fenofibrate
  • Fenofibric Acid
  • Pravastatin
  • Simeprevir
  • Simvastatin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Gout or
  • Muscle problems or
  • Tendon problems, or history of—Use with caution. May make these conditions worse.
  • Heart problems, including heart attack or
  • Patients with end-stage kidney disease receiving dialysis or
  • Stroke—Use has not been studied in patients with these conditions.
  • Liver disease, moderate or severe—Use with caution. The effects may be increased because of the slower removal of the medicine from the body.

Proper Use

Take this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

This medicine comes with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

Take this medicine with or without food. Swallow the tablet whole. Do not cut, crush, or chew it.

Take this medicine at least 2 hours before or at least 4 hours after using bile acid sequestrants (eg, cholestyramine, colesevelam, colestipol).

Carefully follow your doctor's orders about any special diet.

Dosing

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):
    • To reduce bad cholesterol (LDL) in patients with primary hyperlipidemia and to lower the risk of heart attack and heart procedures:
      • Adults—One tablet once a day . Each tablet contains 180 milligrams (mg) bempedoic acid and 10 mg ezetimibe.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

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 and angioedema, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, large, hive-like swelling on the face, eyelids, mouth, lips, tongue, throat, hands, legs, feet, or sex organs, or trouble breathing or swallowing 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.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Bloody urine
  2. decreased amount of urine
  3. increased blood pressure
  4. increased thirst
  5. loss of appetite
  6. lower back or side pain
  7. nausea
  8. pale skin
  9. swelling of the face, fingers, or lower legs
  10. trouble breathing
  11. unusual bleeding or bruising
  12. unusual tiredness or weakness
  13. vomiting

Less common

  1. Ankle, knee, or great toe joint pain
  2. arm, back, or leg pain
  3. body aches or pain
  4. chest tightness
  5. chills
  6. cough
  7. cough producing mucus
  8. difficulty in moving
  9. difficulty urinating
  10. dizziness
  11. ear congestion
  12. fainting
  13. fast or irregular heartbeat
  14. fever
  15. frequent urination
  16. gaseous stomach pain
  17. headache
  18. joint pain, stiffness, or swelling
  19. loss of voice
  20. muscle pain, spasm, or stiffness
  21. pain or tenderness around the eyes and cheekbones
  22. runny or stuffy nose
  23. sneezing
  24. sore throat
  25. stomach fullness
  26. swelling of the feet or lower legs
  27. yellow eyes or skin

Rare

  1. Bone pain

Incidence not known

  1. Black, tarry stools
  2. bleeding gums
  3. blistering, peeling, or loosening of the skin
  4. bloating
  5. chills
  6. constipation
  7. dark urine
  8. diarrhea
  9. difficulty swallowing
  10. hives, itching, skin rash
  11. indigestion
  12. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  13. light-colored stools
  14. muscular tenderness, wasting, or weakness
  15. pains in the stomach, side, or abdomen, possibly radiating to the back
  16. pinpoint red spots on the skin
  17. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  18. recurrent fever
  19. red, irritated eyes
  20. severe nausea or vomiting
  21. sores, ulcers, or white spots in the mouth or on the lips
  22. upper right stomach pain

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

  1. Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  2. discouragement
  3. feeling sad or empty
  4. irritability
  5. loss of interest or pleasure
  6. trouble concentrating
  7. trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: May 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/bempedoic-acid-and-ezetimibe-oral-route/before-using/drg-20484112