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Nexlizet

Pronunciation: NEX-lee-zet
Generic name: bempedoic acid and ezetimibe
Dosage form: oral tablets
Drug class: Antihyperlipidemic combinations

Medically reviewed by Carmen Pope, BPharm. Last updated on Apr 18, 2024.

What is Nexlizet?

Nexlizet (bempedoic acid and ezetimibe) is an oral combination tablet that combines an ACL inhibitor (bempedoic acid) with a cholesterol absorption inhibitor (ezetimibe) that may be used to reduce LDL-C levels in adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH), alone or in combination with other LDL-C lowering therapies. Should be used in addition to dietary changes.

The bempedoic acid component helps to reduce the risk of a heart attack or the need to undergo cardiac procedures to restore blood flow (coronary revascularization) in adults with established cardiovascular disease (CVD), or, without CVD but at high risk for a CVD event, who are unable to take (or do not take) recommended statin therapy.

Nexlizet works by blocking an enzyme called adenosine triphosphate-citrate lyase (ACL) that is involved in the production of cholesterol by the liver (bempedoic acid component). This lowers LDL-C levels in the blood. The ezetimibe component reduces blood cholesterol by inhibiting the absorption of dietary cholesterol by the sterol transporter, Niemann-Pick C1-Like 1 (NPC1), which is located in the small intestine.

Nexlizet was first FDA-approved on February 26, 2020. There is no Nexlizet generic.

Nexlizet side effects

Nexlizet may cause serious side effects, including the following.

Increased levels of uric acid in your blood (hyperuricemia). This can happen within 4 weeks of you starting Nexlizet and continue throughout your treatment. Your healthcare provider may monitor your blood uric acid levels while you are taking Nexlizet. High levels of blood uric acid may lead to gout. Call your healthcare provider if you have the following symptoms of hyperuricemia and gout:

  • severe foot pain especially in the toe joint
  • warm joints
  • swelling
  • tender joints
  • joint redness.

Gout may happen more in people who have had gout before but can also happen in people who have never had it before.

Tendon rupture or injury. Tendon problems can happen in people who take bempedoic acid, one of the medicines in Nexlizet. Tendons are tough cords of tissue that connect muscles to bones. Symptoms of tendon problems may include pain, swelling, tears, and inflammation of tendons including the arm, shoulder, and back of the ankle (Achilles).

  • Tendon rupture can happen while you are taking Nexlizet. Tendon ruptures can happen within weeks or months of starting Nexlizet.
  • The risk of getting tendon problems while you take Nexlizet is higher if you:
    • are over 60 years of age
    • are taking antibiotics (fluoroquinolones)
    • have had tendon problems
    • are taking steroids (corticosteroids)
    • have renal failure
  • Stop taking Nexlizet immediately and get medical help right away if you get any of the following signs or symptoms of a tendon rupture:
    • hear or feel a snap or pop in a tendon area
    • bruising right after an injury in a tendon area
    • unable to move the affected area or put weight on the affected area
  • Stop taking Nexlizet until tendon rupture has been ruled out by your healthcare provider. The most common areas of pain and swelling are the rotator cuff (the shoulder), the biceps tendon (upper arm), and the Achilles tendon at the back of the ankle. This can happen with other tendons.
  • Talk to your healthcare provider about the risk of tendon rupture with continued use of Nexlizet. You may need a different lipid-lowering medicine to treat your cholesterol levels.

The most common side effects of Nexlizet affecting 2% or more people include:

  • symptoms of the common cold, flu, or flu-like symptoms
  • back pain
  • bronchitis
  • anemia
  • high uric acid levels
  • diarrhea
  • muscle spasms
  • stomach pain
  • pain in the shoulder, legs, or arms
  • increased liver enzymes
  • fatigue.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects. Ask your healthcare provider or pharmacist for more information.
Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Nexlizet side effects (more detail)

Warnings

The ezetimibe ingredient in Nexlizet may cause hypersensitivity reactions, including anaphylaxis, angioedema, rash, or urticaria. Do not use in people with a known hypersensitivity to ezetimibe. Stop taking Nexlizet and call your healthcare provider, or go to the nearest hospital emergency room right away if you have any signs or symptoms of an allergic reaction including:

  • swelling of your face, lips, mouth, or tongue
  • wheezing
  • severe itching
  • a fast heartbeat or pounding in your chest
  • trouble breathing
  • dizziness or fainting.

It is not known if Nexlizet is safe and effective in:

  • people with severe liver problems
  • severe kidney problems including people with end-stage kidney disease who are on dialysis
  • children under 18 years of age.

Elevations in serum uric acid have occurred. Your healthcare provider will monitor your uric acid levels and symptoms of gout and treat if appropriate.

Nexlizet is associated with an increased risk of tendon rupture within weeks to months of starting treatment. The risk is higher in those who are over 60 years of age, taking corticosteroids or fluoroquinolones, in patients with renal failure, and those with previous tendon disorders. Tell your doctor right away if you experience joint pain, swelling, or inflammation of a joint.

May cause fetal harm. Breastfeeding is not recommended.

Nexlizet cost

The cost of prescription drugs varies depending on your insurance plan and which pharmacy you use. Refer to our price guide page for more information about Nexlizet cost.

You may also be eligible for a Nexlizet copay card or Nexlizet coupon. Ask your doctor or pharmacist if you qualify. There is no Nexlizet generic.

Before taking

Before you start taking Nexlizet, tell your healthcare provider about all your medical conditions, including if you:

Pregnancy

Nexlizet may cause harm to your unborn baby. You and your healthcare provider will decide if you should take it while you are pregnant. If you become pregnant during Nexlizet treatment, tell your healthcare provider right away and call Esperion at 1-833-377-7633 to share information about the health of you and your baby. 

Breastfeeding

It is not known if Nexlizet passes into your breast milk. You and your healthcare provider should decide if you will take Nexlizet or breastfeed. You should not do both.

Nexlizet pregnancy and breastfeeding warnings (more detail)

How should I take Nexlizet?

Take Nexlizet exactly as your healthcare provider tells you to take it. Check with your healthcare provider or pharmacist if you are not sure.

If you take a medicine that lowers cholesterol by binding bile acids, such as colesevelam or cholestyramine, take Nexlizet at least 2 hours before or 4 hours after you take bile acid-binding medicines. Ask your healthcare provider if you are not sure if you take these medicines.

Detailed Nexlizet dosage information

What happens if I miss a dose?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and just go back to your regular dosing schedule. Do not take two doses at once.

What happens if I overdose?

If you take too much Nexlizet, call your poison control center at 1-800-222-1222 or go to the nearest hospital emergency room right away.

What other medicines will affect Nexlizet?

Nexlizet may affect the way other medicines work, and other medicines may affect how Nexlizet works. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Tell your healthcare provider if you take or plan to take:

Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

Storage

Store Nexlizet in the original package at room temperature between 68ºF to 77ºF (20ºC to 25ºC).

Protect from heat and moisture. Do not throw away the packet that helps to keep your medicine dry (desiccant).

Nexlizet comes in a bottle with a child-resistant cap. Keep all medicines out of the reach of children and pets.

Ingredients

Active Ingredients: bempedoic acid and ezetimibe.

Inactive Ingredients: colloidal silicon dioxide, hydroxy propyl cellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone K30, sodium lauryl sulfate, sodium starch glycolate.

Tablet coating: FD&C Blue #1/Brilliant Blue FCF Aluminum Lake, FD&C Blue #2/Indigo Carmine Aluminum Lake, glyceryl monocaprylocaprate, partially hydrolyzed polyvinyl alcohol, sodium lauryl sulfate, talc, and titanium dioxide.

Only available in one strength, as the Nexlizet 180-10 mg tablet, which contains 180 mg bempedoic acid and 10 mg ezetimibe.

Manufacturer

Esperion Therapeutics, Inc.

Popular FAQ

No, Nexlizet does not contain a statin. It is used with diet either alone or with a cholesterol-lowering drug like a statin to help lower cholesterol levels and help protect your heart. Nexlizet contains two medicines that help lower LDL (“bad”) cholesterol: bempedoic acid and ezetimibe.

Nexlizet (bempedoic acid and ezetimibe) lowered LDL (“bad”) cholesterol levels by an average of 38% when added to a patient’s maximum tolerated statin dose in 12-week, placebo-controlled studies. Studies have shown that the bempedoic acid component of Nexlizet can also lower medical problems related to high cholesterol, such as a heart attack, and lower the risk of heart procedures like stent placement or bypass surgery.

You can take Nexlizet at any time of the day with or without food, but take it at the same time each day. If you take medicine that binds bile acids like colesevelam or cholestyramine, take Nexlizet at least 2 hours before or 4 hours after you take these medicines.

Nexlizet (bempedoic acid and ezetimibe) was approved by the FDA in February 2020 to help lower LDL (“bad”) cholesterol in adults, alongside diet. It can be used with or without other lipid-lowering therapies. In 2024 Nexlizet was also approved to lower medical problems related to high cholesterol, such as a heart attack or the risk of heart procedures like stent placement or bypass surgery.

No, Nexlizet contains bempedoic acid and ezetimibe, two medicines that help lower LDL (“bad”) cholesterol, but Nexletol only contains bempedoic acid. Bempedoic acid also helps to lower medical problems related to high cholesterol, such as a heart attack or the risk of heart procedures like stent placement or bypass surgery. 

Yes, muscle spasms, which may be painful, are a side effect of Nexlizet. In studies, muscle spasms occurred in 3.6% of patients compared to 2.3% taking placebo (inactive pill). Nexlizet is sometimes taken with a statin medicine which may also cause muscle pain or weakness.

Yes, fatigue (tiredness) can occur with Nexlizet but it does not occur too frequently. In studies, fatigue occurred in 2.4% of patients (or 2.4 out of every 100 patients) compared to 1.5% of those taking a placebo (inactive pill).

Weight loss or weight gain are not side effects mentioned in the product information for Nexlizet, nor could any anecdotal reports of weight loss or weight gain be found on common medication blog sites. Cholesterol-lowering drugs, such as Nexlizet, don’t usually affect a person’s weight. Continue reading

Nexlizet (bempedoic acid and ezetimibe) is not a statin medicine, but is used with or without a statin, diet and exercise to lower your cholesterol levels. Nexlizet contains two medicines that act in different ways to lower LDL (“bad”) cholesterol for certain types of high cholesterol. Continue reading

References

  1. Product Label

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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