Nexlizet is a brand-name oral tablet prescribed to lower cholesterol in adults. Nexlizet contains two active ingredients: bempedoic acid and ezetimibe. It belongs to a drug class called adenosine triphosphate-citrate lyase inhibitors.

Specifically, the Food and Drug Administration (FDA) has approved Nexlizet to reduce low-density lipoprotein (LDL) cholesterol in adults with high cholesterol, along with a healthy diet.

Nexlizet may also be used to reduce the risk of heart attack and coronary revascularization (a type of heart procedure) in certain adults.

Nexlizet is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active ingredient in a brand-name medication. Generics usually cost less than brand-name drugs.

The Nexlizet dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Nexlizet to treat
  • your age
  • other medical conditions you may have

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Drug form and strength

Nexlizet comes as a tablet that you swallow.

It’s available in one strength: 180 milligrams (mg) of bempedoic acid and 10 mg of ezetimibe.

Dosage for reducing LDL cholesterol

Nexlizet is approved to help reduce low-density lipoprotein (LDL) cholesterol in certain adults.

The recommended dosage for this purpose is one tablet once per day. The drug can be taken with or without food.

Dosage for reducing certain cardiovascular risks

Nexlizet is approved to help reduce the risk of heart attack and coronary revascularization (a type of heart procedure) in certain adults.

The recommended dosage for this purpose is one tablet once per day. The drug can be taken with or without food.

About taking Nexlizet

You’ll find information about key dosage issues here:

  • When to take: You should take Nexlizet around the same time of day each day. This helps keep a steady level of the drug in your body so it can work effectively.
  • If you miss a dose: If you miss a dose, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Don’t take extra tablets to make up for your missed dose.
  • Taking Nexlizet with food: You may take Nexlizet with or without food.
  • Crushing, splitting, or chewing Nexlizet: Do not cut, crush, or chew the tablet. Swallow it whole.
  • Length of use: Nexlizet is meant to be a long-term treatment. If you and your doctor determine that Nexlizet is safe and effective for you, you’ll likely take it long term.

Overdose

Do not use more Nexlizet than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Nexlizet

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number or go to the nearest emergency room right away.

Nexlizet can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Nexlizet. These lists do not include all possible side effects.

For more information about the possible side effects of Nexlizet, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Nexlizet and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Below is a partial list of mild side effects of Nexlizet. To learn about other mild side effects, talk with your doctor or pharmacist, or see Nexlizet’s prescribing information.

Mild side effects of Nexlizet can include:

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Nexlizet aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or you think you’re having a medical emergency.

Serious side effects of Nexlizet include:

Allergic reaction

For some people, Nexlizet can cause an allergic reaction.

But it’s not clear whether this side effect occurred in the drug’s studies.

In general, symptoms of an allergic reaction can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to x drug, your doctor may recommend a different medication instead.

The Food and Drug Administration (FDA) approves prescription drugs such as Nexlizet to treat certain conditions. Nexlizet may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is used for a purpose other than what it’s approved for.

Nexlizet for reducing LDL cholesterol

Nexlizet is FDA approved to help reduce LDL cholesterol in adults. (LDL cholesterol is also known as “bad” cholesterol.) This drug is typically prescribed along with diet and exercise. Doctors may prescribe Nexlizet with or without a statin drug. It’s approved for this use in adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH).

Nexlizet for reducing cardiovascular risks

Nexlizet is also FDA approved to help reduce the risk of heart attack and coronary revascularization (a type of heart procedure). This drug is prescribed to help decrease these risks when statins cannot be used. Nexlizet is approved for this purpose in adults with cardiovascular disease (CVD) or an increased risk of developing CVD.

Nexlizet contains two active drugs: bempedoic acid and ezetimibe. Bempedoic acid belongs to a group of drugs called adenosine triphosphate-citrate lyase inhibitors. This drug is specifically approved to lower the risk of heart attack and coronary revascularization. Ezetimibe works for the purpose described above.

Nexlizet and children

Nexlizet isn’t approved for use in children. It’s not known if the drug is safe or effective for children.

Nexlizet can interact with several other medications.* It may also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

* These interactions were seen in separate studies of Nexlizet’s two active ingredients, bempedoic acid and ezetimibe. Clinical studies of possible drug interactions with Nexlizet haven’t been done.

Nexlizet and other medications

Below are examples of medications that can interact with Nexlizet. This section does not contain all drugs that may interact with Nexlizet.

Before taking Nexlizet, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Nexlizet and certain statin drugs

Nexlizet may be taken with or without a statin drug to help reduce low-density lipoprotein (LDL) cholesterol. Statins are a group of drugs used to treat high cholesterol.

But Nexlizet may interact with two specific statins: simvastatin (Zocor) and pravastatin (Pravachol). Nexlizet can raise the levels of these statins in your blood. Simvastatin and pravastatin can cause muscle pain and muscle weakness. So, your risk for these muscle side effects may increase if you take Nexlizet with either of these statins.

If you take Nexlizet with one of these statins, your doctor will likely decrease your statin dose.

Before starting Nexlizet, if you’re taking a statin, be sure to tell your doctor which one you take.

Nexlizet and cyclosporine

Taking Nexlizet with cyclosporine (an immunosuppressant drug) can raise the levels of both cyclosporine and ezetimibe in your body. (Ezetimibe is one of the active ingredients in Nexlizet.) This can increase your risk for side effects from either medication.

If you’re taking cyclosporine, talk with your doctor about whether it’s safe for you to take Nexlizet.

Nexlizet and fibrate drugs

Nexlizet shouldn’t be taken with certain fibrate drugs that are used to treat high cholesterol.

Both ezetimibe (one of the active ingredients in Nexlizet) and fibrate drugs can increase the amount of cholesterol stored in your gallbladder. This can cause gallstones. So, using Nexlizet with medications in the fibrate drug class can increase your risk for gallstones even more.

Symptoms of gallstones may include pain in the back, the shoulder, or the right side of the body (below the ribs).

It may be safe to use Nexlizet with fenofibrate (Fenoglide, Tricor, Triglide). But the use of Nexlizet with fibrates other than fenofibrate isn’t recommended.

If you have questions about using Nexlizet with fibrate drugs, talk with your doctor.

Nexlizet and bile acid sequestrant drugs

Nexlizet can interact with bile acid sequestrants, which are a group of drugs used to treat high cholesterol. Examples of bile acid sequestrants include cholestyramine (Prevalite) and colesevelam (Welchol).

Bile acid sequestrants can attach to ezetimibe, one of the active drugs in Nexlizet. This may prevent your body from absorbing Nexlizet, which could make it less effective in treating your condition.

If you take Nexlizet and a bile acid sequestrant, wait at least 2 hours before or 4 hours after taking the bile acid sequestrant to take Nexlizet.

Nexlizet and drugs that raise your risk for tendon ruptures

Taking Nexlizet with drugs that can cause a may raise your risk for this side effect even more. This is because tendon ruptures can also occur with Nexlizet.

Examples of drugs that can raise your risk for a tendon rupture if taken with Nexlizet include corticosteroids and fluoroquinolones (a type of antibiotic). Methylprednisolone (Medrol) is an example of a corticosteroid. And levofloxacin (Levaquin) is an example of a fluoroquinolone.

Be sure to tell your doctor if you’re taking either of these drugs before you start Nexlizet. If you’re prescribed these drugs after you’ve started Nexlizet, tell your doctor that as well. They may suggest other treatments for your conditions.

Nexlizet and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Nexlizet. But you should still check with your doctor or pharmacist before using any of these products while taking Nexlizet.

Nexlizet and foods

There aren’t any foods that have been specifically reported to interact with Nexlizet. But you’ll likely take Nexlizet with a statin drug. And if you do, you’ll need to avoid eating grapefruit or drinking grapefruit juice.

It isn’t safe to consume grapefruit while using certain statins. Grapefruit can prevent statins from clearing out of your body. This can raise your statin levels and increase your risk for side effects. Examples of statins include atorvastatin (Lipitor) and simvastatin (Zocor).

Talk with your doctor if you have questions about eating certain foods with Nexlizet.

As with all medications, the cost of Nexlizet can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Drug coupons: You can visit Optum Perks for price estimates for Nexlizet. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Financial and insurance assistance: If you need financial support to pay for Nexlizet, or if you need help understanding your insurance coverage, help is available.

Esperion Therapeutics, Inc., the manufacturer of Nexlizet, offers a Co-Pay Card that may help lower the amount you pay for the drug. For more information and to find out if you’re eligible, call 855-699-8814 or visit the manufacturer’s website.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Nexlizet, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other drugs that may be used to treat your condition include:

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when an FDA-approved drug is used for a purpose other than what it’s approved for.

You may wonder how Nexlizet compares with other medications that are prescribed for similar uses. Here, we look at how Nexlizet and Nexletol are alike and different.

The Food and Drug Administration (FDA) has approved both Nexlizet and Nexletol to help reduce:

Both Nexlizet and Nexletol contain bempedoic acid (in the same strength) as an active ingredient. But Nexlizet also contains another active ingredient, ezetimibe.

Taking ezetimibe and bempedoic acid together can help reduce LDL cholesterol even more than taking bempedoic acid by itself. For this reason, your doctor may recommend that you take both bempedoic acid and ezetimibe. If they do, they may prescribe Nexlizet so that you can take bempedoic acid and ezetimibe together in a single pill.

Both Nexlizet and Nexletol are typically taken once per day, with or without food.

If you have questions about how Nexlizet and Nexletol are alike and different, talk with your doctor.

Nexlizet is a brand-name prescription drug. It’s approved to help reduce low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol. This medication can be used along with a statin drug and a low cholesterol diet.

Statin drugs

Nexlizet is typically used with statin drugs to help reduce LDL cholesterol. Statins are another group of drugs used to treat high cholesterol.

But Nexlizet may interact with two specific statins: simvastatin (Zocor) and pravastatin (Pravachol). Before taking Nexlizet, let your doctor know if you take either of these statins. They’ll likely reduce your statin dose. (For more information about this interaction, see the “Nexlizet interactions” section.)

Talk with your doctor or pharmacist if you have any questions about taking a statin with Nexlizet.

Other cholesterol-lowering drugs

Some people may have troublesome side effects from statins that prevent them from being able to take these drugs. People bothered by statin side effects may use Nexlizet with other drugs that reduce LDL cholesterol instead of statins.

But there are limitations to using Nexlizet with certain cholesterol-lowering drugs. Examples of these drugs include fibrate drugs and bile acid sequestrants.* (For more information, see the “Nexlizet interactions” section.)

If you have questions about using Nexlizet with other cholesterol-lowering drugs, talk with your doctor or pharmacist.

* If you take Nexlizet while also taking a bile acid sequestrant, Nexlizet should be taken at least 2 hours before or 4 hours after the bile acid sequestrant. Examples of bile acid sequestrants include cholestyramine (Prevalite) and colesevelam (Welchol).

Low cholesterol diet

Cholesterol is made in your body and can also be found in many foods, such as eggs, cheese, and meat. Consuming high amounts of cholesterol in your diet can lead to having high cholesterol in your body.

In addition to taking Nexlizet, your doctor will probably recommend that you follow a low cholesterol diet. Doing so can help lower your cholesterol levels, which can help decrease your risk for heart disease.

For more information on a low cholesterol diet to follow while you take Nexlizet, talk with your doctor.

There are no known interactions between Nexlizet and alcohol.

But drinking in excess can damage your liver. And taking Nexlizet can increase your risk for higher levels of liver enzymes. This can be a sign of liver damage. So, if you take Nexlizet and have a history of excessive alcohol use, you may have a higher risk for this side effect.

Drinking alcohol can also increase the risk of gout. And people with a history of gout may be at a higher risk of having gout while taking Nexlizet.

If you drink alcohol, talk with your doctor about how much, if any, is safe for you to drink while taking Nexlizet. If you have a history of liver problems or drinking in excess, be sure to tell your doctor before you start taking Nexlizet.

The Food and Drug Administration (FDA) has approved Nexlizet to help reduce low-density lipoprotein (LDL) cholesterol and certain cardiovascular risks. It’s approved for use in adults with certain conditions. (For more information about how the drug is used, see the “Nexlizet uses” section.)

What is Nexlizet used to treat?

Cholesterol occurs naturally in your body. It’s a fatty substance that’s made in your liver. Cholesterol can also be found in foods such as eggs, cheese, and meat. It helps your body make vitamins, hormones, and other important substances.

But having more cholesterol than your body can use may lead to serious problems, such as heart disease. Certain genetic (inherited) conditions, such as heterozygous familial hypercholesterolemia (HeFH), can cause high cholesterol. Eating a lot of high cholesterol foods or not getting enough exercise can also raise cholesterol levels.

Nexlizet is specifically approved to help reduce LDL cholesterol. LDL cholesterol is sometimes called “bad” cholesterol. This is because it can build up in the arteries and lead to angina (chest pain) or a heart attack.

Nexlizet is also approved to help reduce the risk of heart attack and coronary revascularization (a type of heart procedure). High cholesterol is a factor that commonly contributes to the development of these risks.

What is Nexlizet’s mechanism of action? What does the drug do?

Nexlizet contains two active drugs: bempedoic acid and ezetimibe. Nexlizet’s mechanism of action (how it works) is to lower your cholesterol in two ways:

  • Bempedoic acid decreases the amount of cholesterol your liver makes. It does this by blocking an enzyme called adenosine triphosphate-citrate lyase.
  • Ezetimibe prevents your small intestine from absorbing cholesterol. As a result, less cholesterol travels from your small intestine to your liver. This causes your liver to break down the cholesterol it already has stored. When this happens, your liver can clear more cholesterol from your blood.

How long does it take to work?

Nexlizet starts working right away to decrease your LDL cholesterol. But you likely won’t be able to feel Nexlizet decreasing your cholesterol. This is because high cholesterol doesn’t usually cause any symptoms.

Your doctor will order a blood test to check your cholesterol levels about 8 to 12 weeks after you start treatment. This will help determine if Nexlizet is working for you.

It isn’t known whether Nexlizet is safe to use during pregnancy. It hasn’t been studied in pregnancy. But based on the way Nexlizet works in your body, it may not be safe to take while pregnant.

Animal studies haven’t shown any harm to offspring if used during pregnancy. But animal studies don’t always predict what will happen in humans.

Talk with your doctor before starting Nexlizet if you’re pregnant or planning a pregnancy.

It’s not known if Nexlizet is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Nexlizet.

For more information about taking Nexlizet during pregnancy, see the “Nexlizet and pregnancy” section.

Breastfeeding isn’t recommended while taking Nexlizet. It’s not known if the drug can pass into breast milk while breastfeeding. If it does pass into breast milk, the drug may cause serious side effects in a child who is breastfed.

Talk with your doctor if you have questions about breastfeeding while taking Nexlizet.

Here are answers to some frequently asked questions about Nexlizet.

Will Nexlizet cure my high cholesterol?

No, Nexlizet won’t cure high levels of low-density lipoprotein (LDL) cholesterol. (LDL cholesterol is also known as “bad” cholesterol.) There currently isn’t a cure for this.

But Nexlizet has been found effective in helping reduce LDL cholesterol. It’s used in combination with a low cholesterol diet and a statin drug. Nexlizet works by decreasing the amount of cholesterol made in your liver. It also helps prevent your small intestine from absorbing cholesterol.

Nexlizet should keep helping decrease your LDL cholesterol for as long as you take it. But once you stop taking the drug, your LDL cholesterol may increase again.

If you have questions about how Nexlizet works to decrease your LDL cholesterol, talk with your doctor.

Is Nexlizet a statin?

No, Nexlizet isn’t a statin. Nexlizet contains two active drugs: bempedoic acid and ezetimibe. Bempedoic acid belongs to a group of drugs called adenosine triphosphate-citrate lyase (ACL) inhibitors. Ezetimibe belongs to a group of drugs called cholesterol absorption inhibitors.

Both Nexlizet and statins work by preventing your liver from making new cholesterol. Nexlizet does this by blocking ACL, which is an enzyme (a protein that speeds up the chemical processes in your body). But statins work by blocking a different enzyme called HMG-CoA reductase.

If you take Nexlizet to reduce cholesterol, your doctor may prescribe Nexlizet with or without a statin drug. If you have questions about the differences between Nexlizet and statin drugs, talk with your doctor.

Does Nexlizet have to be used with a statin?

It’s possible, depending on your condition and treatment plan.

Nexlizet is approved to help reduce low-density lipoprotein (LDL) cholesterol with diet and exercise. For this purpose, it can also be prescribed in combination with or without a statin drug. Examples of statins include atorvastatin (Lipitor) and rosuvastatin (Crestor).

Nexlizet is also approved to help reduce the risk of heart attack and coronary revascularization (a type of heart procedure). Nexlizet is prescribed for this purpose when statins cannot be used.

Statins also help lower the risk of heart problems and death related to high cholesterol. It isn’t known how Nexlizet may affect these risks. If your doctor prescribes Nexlizet with a statin, it’s important to keep using the statin.

Certain statins may interact with Nexlizet, however. For more information, see the “Nexlizet interactions” section. If you have questions about taking Nexlizet with statin drugs, talk with your doctor.

Are there other cholesterol-lowering drugs that are safe to use with Nexlizet?

Yes, there are other cholesterol-lowering drugs that are safe to use with Nexlizet.

Nexlizet may be used with statin drugs to help reduce LDL cholesterol. (See “Does Nexlizet have to be used with a statin?” above for more information.)

But some people may have troublesome side effects from statins that prevent them from being able to take these drugs. People bothered by statin side effects may use Nexlizet without another medication or with other drugs that reduce LDL cholesterol instead of statins.

It’s important to note that there are limitations to using Nexlizet with certain cholesterol-lowering drugs. Examples of these drugs include fibrate drugs and bile acid sequestrants. For more information, see the “Nexlizet interactions” section.

If you have questions about using Nexlizet with other drugs, talk with your doctor or pharmacist.

Could Nexlizet affect my liver or kidneys?

Yes, Nexlizet may affect the liver and kidneys.

In clinical studies, bempedoic acid was shown to increase levels of liver enzymes. (Bempedoic acid is one of Nexlizet’s active ingredients.) Increased liver enzymes can be a sign that your liver isn’t working correctly.

Bempedoic acid was also shown to decrease kidney function. It can affect certain laboratory test levels or lead to blood in the urine. These kidney-related side effects were common in clinical trials of Nexlizet.

Talk with your doctor if you have questions about how Nexlizet may affect your liver or kidneys.

Before taking Nexlizet, talk with your doctor about your health history. Nexlizet may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Gout: Nexlizet may cause hyperuricemia, which can lead to gout. You may be at higher risk for gout while taking Nexlizet if you’ve had gout in the past. For this reason, it’s important to tell your doctor if you have a history of gout before you start taking the drug. You’ll likely have your levels of uric acid monitored while you’re taking Nexlizet. Be sure to tell your doctor if you have any sudden pain, swelling, redness, or deepening of color in your joints while taking the drug. If you do, they may prescribe medications to lower your uric acid levels. For more information about this side effect, see “Hyperuricemia” in the “Nexlizet side effects” section.
  • Tendon problems: Tendon ruptures can happen while taking Nexlizet. Your risk for this side effect may be higher if you have tendon problems or have had them in the past. Before you start Nexlizet treatment, tell your doctor if you have a history of tendon problems. If so, they may recommend a treatment other than Nexlizet for lowering your cholesterol levels.
  • Kidney problems: Certain kidney problems, such as kidney failure, can increase your risk of tendon ruptures while taking Nexlizet. If you have kidney problems, talk with your doctor about whether it’s safe for you to use Nexlizet.
  • Liver problems: Nexlizet may cause increased levels of liver enzymes. This can be a sign that your liver isn’t working correctly. If you have liver problems, such as liver failure, taking Nexlizet can worsen these problems. If you have liver problems, talk with your doctor about whether it’s safe for you to use Nexlizet.
  • Allergic reaction: If you’ve had an allergic reaction to Nexlizet or any of its ingredients, you shouldn’t take this drug. Ask your doctor about which other medications may be better options for you.
  • Pregnancy: It’s not known if Nexlizet is safe to use during pregnancy. For more information, see the “Nexlizet and pregnancy” section.
  • Breastfeeding: Breastfeeding isn’t recommended while taking Nexlizet. For more information, see the “Nexlizet and breastfeeding” section.

Disclaimer: Medical News Today 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.

Nexlizet images

VIEW GALLERY1