Nexletol (bempedoic acid) is a prescription drug that helps treat high cholesterol levels. Nexletol can cause side effects that range from mild to serious, such as muscle spasms and back pain.

Nexletol is used in adults to lower LDL cholesterol along with a low cholesterol diet and statin medication. Specifically, it treats:

It’s not known whether Nexletol can lower the risk of cardiovascular disease or death.

Nexletol comes as a tablet you swallow. It contains the active ingredient bempedoic acid. (An active ingredient is what makes a drug work.)

Keep reading to learn about the common, mild, and serious side effects that Nexletol can cause. For a general overview of the drug, including details about its uses, see this article.

Nexletol treatment can cause mild to serious side effects. Examples of the drug’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

Mild side effects have been reported with Nexletol. These include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Nexletol unless your doctor recommends it.

Nexletol may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Serious side effects have been reported with Nexletol. These include:

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Nexletol, but this side effect wasn’t reported in studies.

If you develop serious side effects while taking Nexletol, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Nexletol, visit MedWatch.

Get answers to some frequently asked questions about Nexletol’s side effects.

Can Nexletol cause weight gain or weight loss?

No. There were no reports of weight changes, such as weight gain or weight loss, in studies of Nexletol. If you’re experiencing changes in your weight, talk with your doctor. They can review possible causes, including other drugs you’re taking or certain lifestyle factors such as your diet.

If you have unintentional weight loss with abdominal pain (a side effect of Nexletol), call your doctor. They can check your liver function and other possible causes of weight loss.

If you have concerns about weight changes with Nexletol treatment, talk with your doctor. They can offer suggestions on ways to manage a moderate weight.

How do side effects of Nexletol compare with those of statin drugs?

Doctors prescribe Nexletol with a statin medication and a low cholesterol diet to manage high cholesterol and for those with certain risks of cardiovascular disease.

These two drugs have some similar and different side effects. For example, both Nexletol and some statin drugs can cause:

But Nexletol can also cause different side effects, including hyperuricemia which was reported in the drug’s studies.

Some statins can cause other kinds of side effects, such as raised blood sugar levels. You may have a higher risk of certain common side effects of both Nexletol and statins when taking these drugs together.

To learn more about the side effects of statins, see this article. Your doctor or pharmacist can also provide information about how the side effects of these drugs compare.

Is hair loss a side effect of Nexletol?

No. There were no reports of hair loss as a side effect in Nexletol studies. But hair loss may have other causes, such as other conditions you may have or other drugs you take. For example, studies show certain medications can cause hair loss. This is a rare side effect of some statin drugs. And doctors prescribe Nexletol along with a statin.

If you’re concerned about hair loss, talk with your doctor or pharmacist. They can tell you about possible causes and ways to manage it.

Learn more about some of the side effects Nexletol may cause.

Muscle spasms

Muscle spasms were a common but mild side effect reported by people taking Nexletol in studies.

Muscle spasms or pain may also be a side effect of other drugs you take. For example, doctors usually prescribe Nexletol with a statin, and these medications often cause muscle-related problems, such as pain or weakness. Taking both medications may increase your risk of muscle spasms.

What might help

Muscle spasms are usually mild and should be a temporary side effect of Nexletol. But if you have muscle spasms that are ongoing or bothersome, talk with your doctor. For mild pain, they may suggest:

If you have severe muscle spasms or pain, call your doctor right away. They can diagnose the cause and discuss treatment options with you. Sometimes, they may have you stop taking Nexletol and will prescribe a different treatment.

Abdominal pain or discomfort

Nexletol can cause abdominal discomfort or pain, with pain occurring in the upper or lower abdomen. This was a common but mild side effect of the drug reported in studies. There may be other causes of abdominal pain, such as other health conditions you have or other drugs you take.

What might help

Abdominal pain or discomfort is usually a mild side effect that should ease after a few days to weeks of treatment. But if you have bothersome or ongoing pain, call your doctor. They’ll help determine the cause and decide if you need to stop taking Nexletol.

Anemia

Nexletol can cause anemia (low level of red blood cells). This was a mild side effect of the drug reported in studies. If you have anemia, tell your doctor. They’ll decide if you can take Nexletol. Most people who developed anemia did not need treatment for the condition. Symptoms include:

What might help

If you have symptoms of anemia while taking Nexletol, call your doctor. They’ll likely order blood tests to check your blood count levels and decide if you can continue taking Nexletol. If you do continue taking the drug, they may monitor you closely for anemia.

High uric acid levels

Nexletol can cause hyperuricemia, a condition in which you have an increased level of uric acid in your blood. This is a rare but serious side effect of Nexletol. Your levels may increase during the first 4 weeks of treatment and remain high while you’re taking this drug. Sometimes, this could increase your risk of developing gout (a type of arthritis).

You may not notice symptoms of hyperuricemia. But some you might notice include:

  • severe foot pain, especially in the big toe
  • joint swelling
  • tender, discolored, or warm joints

What might help

Before starting treatment with Nexletol, tell your doctor if you or a family member has gout or high uric acid levels. Your doctor may not prescribe Nexletol in this case because this may increase your risk of developing high uric acid levels.

Be sure to drink plenty of water while taking Nexletol. If you experience symptoms of hyperuricemia, call your doctor. They’ll check your uric acid levels to diagnose your condition. Sometimes, they may prescribe a drug such as Zyloprim (allopurinol) or Uloric (febuxostat) to lower your uric acid levels.

Your doctor will decide whether it’s safe for you to continue taking Nexletol or if you should switch to a different treatment.

Allergic reaction

Like most drugs, Nexletol can cause an allergic reaction in some people. But this side effect was not reported in studies. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you swallow, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Nexletol, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Nexletol, they may have you switch to a different treatment.

Keeping track of side effects

During your Nexletol treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Taking notes and sharing them with your doctor will help them learn more about how Nexletol affects you. They can then use this information to adjust your treatment plan if needed.

Nexletol may not be right for you if you have certain medical conditions. This is known as a drug-condition interaction. Other factors may also affect whether Nexletol is a good treatment option for you. Talk with your doctor about your health history before starting this drug. Factors to consider include those described below.

Kidney problems. Nexletol is likely safe to take if you have mild to moderate kidney problems. But it’s not known if the drug is safe to take if you have severe kidney problems such as end-stage kidney disease and you’re on dialysis.

Talk with your doctor if you have kidney problems. They’ll determine whether you can take Nexletol. In some cases, having severe kidney problems may increase your risk of a tendon rupture, which is a serious potential side effect of Nexletol.

Risk factors for tendon rupture. Tell your doctor if you have a history of tendon rupture or tear. Taking Nexletol can increase your risk of this occurring. Certain factors can increase the risk of this side effect. These include being older than age 60 years, having kidney failure, or taking certain drugs, such as corticosteroids or fluoroquinolones (a kind of antibiotic).

Your doctor likely won’t prescribe Nexletol if you’ve had a tendon rupture in the past or have an increased risk of this side effect. They’ll discuss safer treatment options with you.

Allergic reaction. If you’ve had an allergic reaction to Nexletol or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Gout. Nexletol can raise uric acid levels which can increase your risk of developing gout. If you have hyperuricemia (high uric acid) or gout, or a family history of either, tell your doctor. Taking Nexletol could worsen your condition. If you develop high uric acid levels or gout symptoms while taking this drug, call your doctor. They’ll determine whether you need treatment for your hyperuricemia and if you should stop taking Nexletol.

Liver problems. Taking Nexletol can increase your liver enzymes. It’s not known whether this drug may worsen serious liver problems or cause liver damage in certain cases. If you have severe liver problems, tell your doctor. They’ll decide if it’s safe for you to take Nexletol.

Alcohol and Nexletol

There are no known interactions between Nexletol and alcohol, but Nexletol can increase your liver enzyme levels. Drinking too much alcohol while taking this drug may increase your risk of liver problems. If you plan to consume alcohol while taking Nexletol, ask your doctor how much, if any, is safe.

Pregnancy and breastfeeding while taking Nexletol

Nexletol is not recommended for use during pregnancy. The effects of this drug during pregnancy are not known. But it may cause fetal harm due to how it works in the body to lower cholesterol.

If you’re pregnant or planning to become pregnant, tell your doctor. They’ll likely not prescribe Nexletol for you during this time.

There is a pregnancy monitoring program for people taking Nexletol during pregnancy. If you’re taking the drug while pregnant, your doctor will likely report any side effects you have to this program.

It’s not known whether Nexletol passes into breast milk. The drug is not recommended for use while breastfeeding because it may not be safe for your child. If you’re taking Nexletol, your doctor will likely suggest an alternate way to feed your child.

Nexletol can cause mild to serious side effects. While most side effects of the drug are mild, serious side effects are possible in rare cases. If you have questions about side effects that Nexletol can cause, talk with your doctor. Examples of questions to help get you started include:

To learn more about Nexletol, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.