Nexlizet (bempedoic acid/ezetimibe) is a prescription oral tablet used to treat high cholesterol in adults. Nexlizet can cause side effects ranging from mild to serious. Examples include mouth pain, constipation, and UTI.
Some people may experience mild to serious side effects during their Nexlizet treatment. Examples of the drug’s commonly reported side effects include:
- urinary tract infection (UTI)
- mouth pain
- inflammation of the nasal (nose) passages and throat
Mild side effects have been reported with Nexlizet. These include:
- fatigue (low energy)
- muscle spasms
- constipation or diarrhea
- anemia (low level of red blood cells)
- elevated liver enzymes (which may be a sign of liver damage)
- respiratory infection, such as bronchitis or flu
- pain in your back, mouth, joints, arms, or legs
- mild allergic reaction*
In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Nexlizet unless your doctor recommends it.
Nexlizet may cause mild side effects other than those listed above. See the drug’s prescribing information for details.
* An allergic reaction is possible after taking Nexlizet, but this side effect was not reported in studies of the drug.
Serious side effects have been reported with Nexlizet. These include:
If you develop serious side effects while taking Nexlizet, call your doctor right away. If the side effects seem life threatening or you think you have a medical emergency, immediately call 911 or your local emergency number.
* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Nexlizet, but this side effect was not reported in studies of the drug.
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 Nexlizet, visit MedWatch.
Get answers to some frequently asked questions about Nexlizet’s side effects.
Can Nexlizet cause weight loss or hair loss?
It’s not likely. Weight loss or hair loss were not reported in studies of Nexlizet. And in general, cholesterol-lowering drugs (such as Nexlizet) don’t usually cause these side effects.
If you’re concerned about weight or hair loss during your Nexlizet treatment, talk with your pharmacist or doctor.
Does Nexlizet cause long-term side effects?
It’s possible. Long-term side effects include those that may start at any time you’re taking a drug, even if you’ve taken it for a long time. It also includes side effects that may not go away, even after you stop taking the drug.
Examples of long-term side effects reported in Nexlizet’s studies include:
If you’re concerned about possible long-term side effects from Nexlizet, talk with your doctor or pharmacist.
Learn more about some of the side effects Nexlizet may cause.
Excess uric acid
Nexlizet can cause excess uric acid in the blood. This was a common side effect reported in studies of the drug. Excess uric acid can occur within 4 weeks of starting Nexlizet and will not go away unless you stop taking Nexlizet.
A high level of uric acid may result in gout. This may cause symptoms such as:
- joint stiffness
- warmth and swelling in the joint
- tenderness in the joint
- severe pain, especially in a toe joint
Factors that can increase the risk of gout when taking Nexlizet include:
- a history of gout or high uric acid
- a diet high in purines (certain fish, shellfish, meats, alcohol, and sugary drinks)
- certain medications such as hydrochlorothiazide or chemotherapy (traditional drugs prescribed to treat cancer)
- diabetes or prediabetes
- dehydration (low fluid level)
What might help
If you have an increased uric acid level during your Nexlizet treatment, consider keeping a food diary to help you avoid foods and drinks that increase your risk of gout. Also, drinking plenty of water can help flush uric acid out of your system.
If you have questions about your risk of excess uric acid, talk with your doctor or pharmacist.
Nexlizet may cause a tendon rupture in some people. This was an uncommon side effect reported in Nexlizet’s studies. Tendon rupture can occur in specific areas such as the shoulder rotator cuff, upper arm biceps tendon, or Achilles tendon on the back of the heel. Symptoms may develop in tendon areas within weeks or months after starting Nexlizet and may include:
- sudden and severe pain
- immediate bruising or swelling
- feeling or hearing a pop
- difficulty walking or moving the affected area
Factors that can increase the risk of ruptured tendon when taking Nexlizet include:
- past tendon problems
- intense exercise
- exercise without correct stretching
- steroid injections into the tendon
- kidney failure
- taking medications such as fluoroquinolones, statins, or aromatase inhibitors
- being over 60 years of age
What might help
If you’re concerned about your risk of tendon rupture with Nexlizet, talk with your doctor. Your doctor may recommend stretching before exercise and avoiding high impact activities such as jumping. Instead, you may want to try low-impact exercises, such as walking or swimming, to relieve stress on tendons.
Symptoms of an allergic reaction can be mild to serious and can include:
- skin rash
- 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 oral antihistamine, 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 Nexlizet, they’ll decide whether you should continue taking it.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty 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 Nexlizet, they may have you switch to a different treatment.
Keeping track of side effects
During your Nexlizet 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
Keeping notes and sharing them with your doctor will help them learn more about how Nexlizet affects you. They can then use this information to adjust your treatment plan if needed.
Below is important information you should consider before taking Nexlizet.
Nexlizet can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Nexlizet is a good treatment option for you.
Talk with your doctor about your health history before you take Nexlizet. Be sure to tell them if any of the following factors apply to you:
- liver problems
- kidney problems
- have had gout before
- tendon problems
- taking other prescription drugs, over-the-counter drugs, supplements, herbals, or vitamins
- past allergic reaction to Nexlizet
Alcohol and Nexlizet
There are no known interactions between alcohol and Nexlizet. However, both alcohol and Nexlizet can increase your risk of gout and elevated liver enzymes. So drinking alcohol during your Nexlizet treatment may further raise your risk of these side effects.
If you have questions about consuming alcohol during Nexlizet treatment, talk with your doctor or pharmacist.
Pregnancy and breastfeeding with Nexlizet
Nexlizet is usually prescribed for someone who’s pregnant or breastfeeding only if the benefits of treatment outweigh the potential risks.
It’s not known whether Nexlizet is safe to take while pregnant. But based on the way the drug works in your body, it may not be safe to take during pregnancy.
If you’re pregnant or planning to become pregnant, talk with your doctor before starting Nexlizet treatment.
If you take Nexlizet while pregnant, consider signing up for the Bempedoic Acid Pregnancy Surveillance Program. (Bempedoic is one of the active drugs in Nexlizet. An active drug is the ingredient that makes a drug work.) A pregnancy registry collects information about the safety of certain medications when taken during pregnancy.
Breastfeeding while taking Nexlizet is not recommended. It’s not known whether the drug passes into breast milk, but if it does, it may cause serious side effects in a child who is breastfed.
If you’re breastfeeding or planning to do so, talk with your doctor about your options.
Like most drugs, Nexlizet can cause side effects that range from mild to serious. However, most are temporary and go away after a few days to weeks. If you have questions about side effects that Nexlizet can cause, talk with your doctor.
Examples of questions you may want to ask include:
- Do I have a higher risk of developing side effects from Nexlizet than others taking the drug?
- Are there any side effects from Nexlizet I should report to you right away?
- Would making any lifestyle or dietary changes while taking Nexlizet reduce my risk of side effects?
To learn more about Nexlizet, see this article.
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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.