Drug Interactions between bempedoic acid and bupivacaine / dexamethasone / epinephrine

MONITOR CLOSELY: Concomitant administration of bempedoic acid may potentiate the risk of tendon rupture or injury associated with fluoroquinolones and corticosteroids. The mechanism is unknown. Tendon rupture or injury have most frequently involved the rotator cuff (the shoulder), biceps tendon, or Achilles tendon. Tendon rupture may occur within weeks to months of starting treatment with bempedoic acid. Tendon rupture may occur more frequently in patients with additional risk factors such as age over 60 years, renal failure, and patients with previous tendon disorders.

MANAGEMENT: Caution is recommended if bempedoic acid is prescribed in combination with corticosteroids or fluoroquinolones, particularly in patients with other concomitant risk factors (e.g., age over 60 years, renal failure, previous tendon disorders). Treatment with bempedoic acid should be stopped immediately if rupture of a tendon occurs. Discontinuation of treatment with bempedoic acid should be considered if the patient experiences joint pain, swelling, or inflammation. At the first sign of tendinitis or tendon rupture, the patient should be instructed to rest, avoid exercise, avoid using the affected area, and to contact their healthcare provider. An alternative therapy should be considered in patients with a history of tendon disorders or tendon rupture.