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Pronunciation: NEX-le-tol
Generic name: bempedoic acid
Dosage form: oral tablet
Drug class: Miscellaneous antihyperlipidemic agents

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

What is Nexletol?

Nexletol (bempedoic acid) is an oral tablet for high cholesterol that may be used to:

Nexletol (bempedoic acid) works by blocking an enzyme called adenosine triphosphate-citrate lyase (ACL) that is involved in the production of cholesterol by the liver. This lowers LDL-C levels in the blood.

Nexletol was first FDA-approved on February 21, 2020. There is no Nexletol generic.

Nexletol side effects

Nexletol may cause serious side effects, including the following:

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

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

Tendon rupture or injury. Tendon problems can happen in people who take Nexletol. 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).

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

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 of Nexletol. For more information, ask your healthcare provider or pharmacist. Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


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

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

Nexletol 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 in 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.

Nexletol 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 Nexletol cost.

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

Before taking Nexletol

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


Nexletol 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 Nexletol 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. 


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

How should I take Nexletol?

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

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 Nexletol, call your poison control center at 1-800-222-1222 or go to the nearest hospital emergency room right away.

What other drugs will affect Nexletol?

Nexletol may affect the way other medicines work, and other medicines may affect how Nexletol 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 simvastatin or pravastatin (other cholesterol-lowering medicines). Taking statins with Nexletol may increase your risk of developing muscle pain or weakness (myopathy).

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


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

Do not throw away the packet that helps to keep your medicine dry (desiccant).

Keep Nexletol and all medicines out of the reach of children.


Active Ingredient: bempedoic acid.

Inactive Ingredients: colloidal silicon dioxide, hydroxyl propyl cellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and sodium starch glycolate.

Tablet coating: partially hydrolyzed polyvinyl alcohol, polyethylene glycol, talc, and titanium dioxide.

Tablets are available in one strength: Nexletol 180 mg. This contains 180 mg of bempedoic acid. There is no Nexletol generic.


Esperion Therapeutics, Inc.

Popular FAQ

The manufacturer has not conducted head-to-head studies to determine if Nexletol can decrease problems related to high cholesterol better than a statin. Nexletol is normally prescribed with a statin. In general, Nexletol has been shown to lower LDL (“bad”) cholesterol by about 18%, while statins lower LDL from 17% to 63%, based on the drug selected and potency.

Nexletol (bempedoic acid) does not cause high blood pressure (hypertension) as a side effect according to the manufacturer’s package insert. However, in a clinical study, more people taking Nexletol (4.3%) had a report of hypertension compared to those on placebo (1.8%).

You can take Nexletol (bempedoic acid) at any time of the day, along with your statin, but take it at the same time each day. Do not take more than 1 dose per day, or as directed by your healthcare provider. Nexletol can be taken with or without food.

Nexletol (bempedoic acid) will start lowering your cholesterol levels right away. Your doctor will check your progress in about 8 to 12 weeks with a blood test. Continue your statin therapy as directed. In studies, LDL-C (“bad”) cholesterol levels declined to their maximum level by the 4th week of treatment.


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Further information

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