Bempedoic acid/ezetimibe Disease Interactions

Ezetimibe is not recommended for use in patients with moderate to severe hepatic impairment (Child-Pugh B or C) due to the unknown effects of increased exposure in this population.

Bempedoic acid has not been studied in patients with severe hepatic impairment (Child-Pugh C), therefore, caution is advised if used in these patients. No dosage adjustment is needed in patients with mild or moderate hepatic impairment (Child-Pugh A or B).

Bempedoic acid can elevate serum uric acid. Caution is advised in patients with a history of gout. Assess uric acid levels periodically and monitor any signs or symptoms of hyperuricemia.

There is limited experience with the use of bempedoic acid in patients with severe renal impairment, and the drug has not been studied in patients with end-stage renal disease (ESRD) receiving dialysis. Caution is advised if used in these patients.

Bempedoic acid has been associated with an increased risk of tendon rupture or injury. Ruptures involving the rotator cuff, biceps, or Achilles tendon have been reported. Risk increases in patients over 60, those on corticosteroid or fluoroquinolone treatment, patients with renal failure, and patients with previous tendon disorders. Consider an alternative therapy in patients with a history of tendon disorders or rupture. Discontinue treatment if rupture of a tendon occurs or consider discontinuation if the patient experiences joint pain, swelling, or inflammation.