- a type of high cholesterol called heterozygous familial hypercholesterolemia (HeFH)
- heart disease related to atherosclerosis (narrowing or hardening of your arteries due to a buildup of cholesterol)
Specifically, Nexlizet is used to lower a type of cholesterol called low-density lipoprotein (LDL), also known as “bad cholesterol.”
For more details about how the drug is used, including its limitations of use, see “What is Nexlizet used for?” below.
Nexlizet comes as a tablet you swallow. It’s a brand-name drug not currently available in generic form.
Nexlizet is a combination drug, which means it contains more than one active ingredient. (An active ingredient is what makes a drug work.) Nexlizet contains:
- bempedoic acid, which is available as the brand-name drug Nexletol
- ezetimibe, which is available in generic form and as the brand-name drug Zetia
Keep reading to learn more about Nexlizet’s side effects, cost, uses, and more.
Like most drugs, Nexlizet may cause mild to serious side effects. The lists below describe some of the more common ones, but they don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Nexlizet. They can also suggest ways to help reduce side effects.
Mild side effects
Below is a list of some of the mild side effects that Nexlizet can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read Nexlizet’s prescribing information.
Mild side effects of Nexlizet that have been reported include:
- respiratory infections, such as:
- urinary tract infection (UTI)
- constipation or diarrhea
- pain in your mouth, back, joints, arms, or legs
- mild changes in blood test results, such as:
- increased liver enzymes
- muscle cramps*
- belly pain*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* For more information about this side effect, see the “Side effect focus” section below.
Serious side effects
Serious side effects from Nexlizet can occur, but they aren’t common. If you have serious side effects from Nexlizet, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Serious side effects of Nexlizet that have been reported include:
* For more information about this side effect, see the “Side effect focus” section below.
Side effect focus
Learn more about some of the side effects Nexlizet may cause.
Some people may have muscle cramps while taking Nexlizet. These are sudden muscle spasms that you can’t control. Affected muscles may feel tight, hard, or painful. Most people who took Nexlizet in studies didn’t have this side effect. But some people had to stop the drug because of severe muscle cramps, though this was rare.
What might help
Muscle cramps usually go away on their own within a few seconds to minutes. Here are a few tips to try when a muscle cramp occurs:
- Stretch the affected area of your body.
- Gently massage the tight or painful area.
- Move around. For example, if a leg cramp occurs while you’re in bed, it can help to get up and walk around.
Staying hydrated may also help prevent muscle cramps. Be sure to drink plenty of fluids each day, especially if you’re exercising in hot weather.
Talk with your doctor if muscle cramps become severe while you’re taking Nexlizet. They may recommend a different treatment option for your condition.
What might help
If you have belly pain while taking Nexlizet, it should go away with continued treatment. Some people find that taking the drug with food helps prevent or lessen this side effect. (Nexlizet may be taken with or without food.)
If this side effect doesn’t go away or becomes severe, tell your doctor. They may want to check you for other causes of belly pain. Or they may prescribe a different cholesterol-lowering drug for you instead of Nexlizet.
Nexlizet contains the active ingredient bempedoic acid. This ingredient may increase the risk of tendon problems. (Tendons are connective tissues that attach muscles to bones.)
Certain factors can further increase the risk of tendon problems with this drug, including:
- having had a tendon rupture or injury in the past
- being ages 60 years or older
- having kidney failure
- taking a corticosteroid medication (such as prednisone) or a fluoroquinolone antibiotic (such as ciprofloxacin)
This side effect wasn’t specifically reported in Nexlizet’s studies. But it occurred rarely in studies that just looked at bempedoic acid, one of the active drugs in Nexlizet. (An active ingredient is what makes a drug work.)
What might help
Before starting Nexlizet, be sure to tell your doctor if any of the factors above apply to you. They may prescribe a different treatment for high cholesterol that doesn’t contain bempedoic acid. Or if you need to take a short course of a steroid or fluoroquinolone antibiotic, they may have you pause Nexlizet treatment temporarily.
If you develop pain or swelling anywhere in your body, rest the affected area and tell your doctor right away. They’ll help you identify the cause of your symptoms. If they confirm you have a tendon injury, they’ll likely have you stop taking Nexlizet.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause you to have trouble breathing.
Call your doctor right away if you have an allergic reaction to Nexlizet. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A Nexlizet Co-Pay Card may also be available. You can also check out this article to learn more about saving money on prescriptions.
Nexlizet is prescribed to treat high cholesterol in adults, along with a low fat diet and a statin medication. Statins are the most commonly prescribed type of drug for high cholesterol. Examples include atorvastatin (Lipitor) and rosuvastatin (Crestor).
Specifically, Nexlizet is used to lower a type of cholesterol called low-density lipoprotein (LDL), also known as “bad cholesterol.” Having too much LDL in your blood can lead to serious health problems, such as heart attack or stroke.
Nexlizet is used to lower LDL in adults with either:
- heterozygous familial hypercholesterolemia (HeFH), a type of high cholesterol that runs in families
- cardiovascular (heart and blood vessel) disease related to atherosclerosis (narrowing or hardening of your arteries due to a buildup of cholesterol)
Nexlizet is prescribed to further reduce LDL when you’re already taking a statin at the highest dose you can tolerate.
It’s not known if Nexlizet decreases the risk of heart problems or death due to high cholesterol. This is a limitation of the drug’s use.
Below is the most commonly used dosage of Nexlizet, but always take the dosage your doctor prescribes.
Form and strength
Nexlizet comes as a tablet you swallow. It’s a combination drug, which means it contains more than one active ingredient. (An active ingredient is what makes a drug work.) Nexlizet contains:
- 180 milligrams (mg) of bempedoic acid
- 10 mg of ezetimibe
This strength may be written as 180 mg/10 mg.
Nexlizet is typically taken once per day.
Questions about Nexlizet’s dosage
Below are some common questions about Nexlizet’s dosage.
- What if I miss a dose of Nexlizet? If you miss a dose of Nexlizet, take it as soon as you remember. But if it’s almost time for your next dose, skip the one you missed. Then take your next dose at your usual time.
- Will I need to take Nexlizet long term? If you and your doctor agree that Nexlizet is working well for you, you’ll likely take it long term.
- How long does Nexlizet take to work? It may take up to 2 or 3 months for Nexlizet to work. Within this time frame, your doctor will order a lipid panel blood test to check how well the drug is working to lower your cholesterol.
Below are answers to some frequently asked questions about Nexlizet.
Is Nexlizet a statin?
Statins don’t always lower cholesterol enough, though. And some people need a high dose statin to reach their ideal cholesterol level, but their side effects, such as muscle pain, are too bothersome.
Nexlizet and statins are both used to treat high cholesterol, but they work in different ways. Nexlizet is meant to further lower LDL when you’re already taking a statin in the highest dose that you can tolerate.
Your doctor can tell you more about your cholesterol levels and treatment goals.
Does Nexlizet cause weight loss?
You’re meant to follow a low fat diet during Nexlizet treatment for high cholesterol. Weight loss can occur if you’re consuming fewer calories as part of this low fat diet.
If you have questions about following a low fat diet, talk with your doctor or a dietitian. They can suggest a plan to help you reach or maintain a weight that’s healthy for you.
Are there alternatives to Nexlizet that could treat my condition?
Bempedoic acid is an adenosine triphosphate-citrate lyase (ACL) inhibitor. It’s available as the brand-name drug Nexletol. Bempedoic acid is currently the only drug of its kind, so there are no alternatives that work exactly the same way.
Ezetimibe is a selective cholesterol absorption inhibitor. It’s available in generic form and as the brand-name drug Zetia. Ezetimibe is currently the only drug of its kind.
Other cholesterol-lowering drugs are available that work differently than Nexlizet. Some examples include:
- statins, such as atorvastatin (Lipitor) and rosuvastatin (Crestor)
- PCSK9 inhibitors, such as alirocumab (Praluent)
- fibrates, such as fenofibrate (Fenoglide, Tricor)
- bile acid sequestrants, such as colesevelam (Welchol)
If you have questions about alternatives to Nexlizet that may be right for you, talk with your doctor.
Nexlizet and Nexletol are both cholesterol-lowering drugs. They are similar in that they both contain the active ingredient bempedoic acid. But Nexlizet is different because it’s a combination drug, which is a drug that contains more than one active ingredient. (An active ingredient is what makes a drug work.) Nexlizet also contains ezetimibe.
To learn more about how Nexlizet and Nexletol compare, check out this article. You can also talk with your doctor for more information on how these drugs are alike and different.
Your doctor will explain how you should take Nexlizet. They’ll also explain how much to take and how often to take it. Be sure to follow your doctor’s instructions.
Nexlizet comes as a tablet you swallow.
You’ll take Nexlizet once per day. There’s no best time of day to take your dose, but it’s a good idea to take it around the same time each day.
If you also take a statin drug once daily, you can take Nexlizet at the same time.
Accessible medication containers and labels
If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies provide medication labels that:
- have large print
- use braille
- contain a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.
And if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Nexlizet in an easy-open container. They may also be able to recommend tools or tips to help make it simpler to open the drug’s container.
Taking Nexlizet with other drugs
Examples of statins include:
- atorvastatin (Lipitor)
- lovastatin (Altoprev)
- rosuvastatin (Crestor)
- pravastatin* (Pravachol)
- simvastatin* (Zocor)
You can take your statin drug at the same time you take Nexlizet.
* Certain strengths of pravastatin and simvastatin can interact with Nexlizet. For more details, talk with your doctor or pharmacist and see the “Interactions” section below.
Questions about taking Nexlizet
Below are some common questions about taking Nexlizet.
- Can Nexlizet be chewed, crushed, or split? No. You should swallow Nexlizet tablets whole. If you have trouble swallowing pills, check out these helpful tips. Or talk with your doctor or pharmacist. They may suggest a different treatment option.
- Should I take Nexlizet with food? You can take Nexlizet with or without food.
Questions for your doctor
You may have questions about Nexlizet and your treatment plan. It’s important to discuss all your concerns with your doctor. Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions, such as:
- How will Nexlizet affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. They want you to get the best care possible, so don’t be afraid to ask questions or offer feedback on your treatment.
Below are some things to consider before starting Nexlizet treatment.
Taking a drug with certain vaccines, foods, and other things can affect how the drug works. These effects are called interactions.
Before starting Nexlizet, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Nexlizet.
Interactions with drugs or supplements
Nexlizet is usually prescribed along with a statin drug, but certain strengths of the following statins may interact with Nexlizet:
If you’re taking one of these drugs, tell your doctor before you start Nexlizet. They’ll likely either lower your dose of that statin or switch you to a different one.
Other types of drugs can also interact with Nexlizet, including:
- bile acid sequestrants such as cholestyramine (Prevalite)
- fenofibrate (Fenoglide, Tricor), a cholesterol-lowering drug
- the immunosuppressant drug cyclosporine (Gengraf, Neoral)
This list does not contain all types of drugs that may interact with Nexlizet. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Nexlizet.
Nexlizet may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting Nexlizet. Factors to consider include those shown below.
High risk of tendon rupture. Tendon rupture is a possible side effect of Nexlizet. You may be more likely to develop this side effect if:
- you’ve had a tendon problem or rupture in the past
- you’re ages 60 years or older
- you have kidney failure
- you take a corticosteroid (such as prednisone) or a fluoroquinolone antibiotic (such as ciprofloxacin)
Severe liver problems. It’s not known if Nexlizet is safe for people with severe liver problems. It may increase liver enzymes as a possible side effect. This can be a sign of liver damage. If you already have liver problems, talk with your doctor. They can help you decide if your liver is healthy enough for treatment with Nexlizet.
Gout arthritis or hyperuricemia (high level of uric acid in your blood). Nexlizet may cause a high level of uric acid in your blood. Before you start Nexlizet, your doctor will test your uric acid level. Be sure to tell them if you have or have had gout. (Gout is a type of arthritis caused by a buildup of uric acid.) Your doctor can tell you if Nexlizet or another treatment option would likely be better for your condition.
Allergic reaction. If you’ve had an allergic reaction to Nexlizet or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better treatment options.
Nexlizet and alcohol
Alcohol doesn’t interact with Nexlizet. For most people, it should be safe to drink alcohol in moderation while taking this drug.
But it was seen in studies that some people taking Nexlizet experienced an increase in their liver enzymes. (Liver enzymes are measured in your blood by liver function tests.) Drinking alcohol, especially in excess, can increase liver enzymes as well.
Talk with your doctor if you have questions about alcohol and Nexlizet.
Pregnancy and breastfeeding
Your doctor will likely recommend that you do not take Nexlizet while pregnant or breastfeeding. This drug may cause harmful effects in a developing fetus or a breastfed child. But this isn’t known for sure.
If you’re pregnant or planning to become pregnant, talk with your doctor before starting Nexlizet. They may suggest other ways to manage your cholesterol during pregnancy.
If you become pregnant while taking the drug, tell your doctor right away. They’ll likely have you stop taking Nexlizet. They may also recommend that you sign up for the Bempedoic Acid Pregnancy Surveillance Program. This program is gathering information to help researchers better understand the drug’s effects on pregnancy. For more information, call 833-377-7633.
If you’re breastfeeding or planning to breastfeed, talk with your doctor before starting Nexlizet. They can discuss your options with you.
Do not take more Nexlizet than your doctor prescribes, as this can lead to serious side effects.
What to do in case you take too much Nexlizet
Call your doctor if you think you’ve taken too much Nexlizet. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
If you have questions or concerns about taking Nexlizet, talk with your doctor or pharmacist. Here are some sample questions to help start your conversation:
- Should I continue taking my other cholesterol medication?
- What foods should I eat (or avoid) to help lower my cholesterol while taking Nexlizet?
- Will taking Nexlizet along with a statin increase my risk of having muscle-related side effects?
- What should I know about Nexlizet compared with other treatment options for high cholesterol?
Does Nexlizet work to lower cholesterol in people who cannot take statins?Anonymous
To treat high cholesterol, Nexlizet is meant to be used together with a statin drug and a low fat diet. Statins are the most commonly prescribed medication for high cholesterol. They are proven to reduce the risk of life threatening heart problems, such as heart attack and stroke, in people with high cholesterol.
In one study, the combined use of bempedoic acid and ezetimibe was effective for reducing low-density lipoproteins (LDL) (also called “bad” cholesterol) in people with statin intolerance. (Nexlizet is a combination drug that contains bempedoic acid and ezetimibe.)
But it’s not known if Nexlizet decreases the risk of heart problems in people with high cholesterol and statin intolerance. Researchers are
Talk with your doctor if you have questions about the best approach for lowering your cholesterol.The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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.