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What Is Nexletol?

Nexletol is a prescription medication containing bempedoic acid, a cholesterol-lowering drug classified as an ATP-citrate lyase inhibitor. It is used alongside diet and exercise to lower low-density lipoprotein cholesterol (LDL-C) in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia. It is also approved to reduce the risk of major cardiovascular events in adults at increased risk who cannot take recommended statin therapy, including those not taking a statin.

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What Is Nexletol?

Nexletol is a prescription medication containing bempedoic acid, a cholesterol-lowering drug classified as an ATP-citrate lyase inhibitor. It is used alongside diet and exercise to lower low-density lipoprotein cholesterol (LDL-C) in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia. It is also approved to reduce the risk of major cardiovascular events in adults at increased risk who cannot take recommended statin therapy, including those not taking a statin.

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How Does Nexletol Work?

Nexletol inhibits ATP-citrate lyase, an enzyme involved in cholesterol production in the liver. Reducing cholesterol synthesis increases the liver's ability to remove LDL cholesterol from the bloodstream. Bempedoic acid is activated primarily in the liver rather than skeletal muscle, distinguishing its mechanism from statins. Lower LDL cholesterol contributes to cardiovascular risk management, although individual treatment decisions depend on cholesterol levels and other health factors.

Who Is Prescribed Nexletol?

Nexletol is prescribed to adults with elevated LDL cholesterol, including those with heterozygous familial hypercholesterolemia. It can be used with other cholesterol-lowering therapies or alone when combination treatment is not possible. Nexletol also reduces the risk of certain major cardiovascular events in adults at increased risk who cannot take recommended statin therapy. A healthcare professional assesses cholesterol levels, cardiovascular risk, current medications, and medical history before prescribing it.

How Should Nexletol Be Taken?

The recommended Nexletol dose is 180 mg orally once daily, with or without food. The tablet should be swallowed according to the prescribing instructions. Nexletol can be used alongside other lipid-lowering medications when appropriate, but certain statin combinations require dose restrictions. Clinicians generally assess LDL cholesterol after treatment begins to determine the response. Patients should continue recommended dietary and lifestyle measures while taking the medication.

What Are the Side Effects and Warnings of Nexletol?

Nexletol can increase uric acid levels and trigger gout in susceptible patients. It also carries a warning for tendon injury or rupture, particularly in patients with certain risk factors. Other reported side effects include muscle spasms, back pain, abdominal discomfort, and increased liver enzymes. Patients should report sudden tendon pain, swelling, or difficulty moving a joint. Clinicians consider medication interactions, including dose limits for simvastatin and pravastatin.

Common Questions About Nexletol

Is Nexletol a statin?

No. Nexletol contains bempedoic acid, an ATP-citrate lyase inhibitor. It lowers cholesterol through a different mechanism from statins.

Does Nexletol lower LDL cholesterol?

Yes. Nexletol reduces LDL cholesterol by decreasing cholesterol production in the liver and increasing LDL removal from the bloodstream.

Can Nexletol be taken without a statin?

Yes. Nexletol can be prescribed without a statin when appropriate, including for certain adults who cannot take recommended statin therapy.

Can Nexletol cause gout?

Yes. Nexletol can increase uric acid levels and trigger gout. Patients should report sudden joint pain, swelling, or redness, particularly in the feet.

References

Bempedoic Acid. LiverTox. https://www.ncbi.nlm.nih.gov/books/NBK593301/. Date Accessed October 19, 2026.

Bempedoic Acid. MedlinePlus. https://medlineplus.gov/druginfo/meds/a620020.html. Date Accessed October 19, 2026.

Bempedoic Acid. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Bempedoic-Acid. Date Accessed October 19, 2026.

Bempedoic Acid. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK594232/. Date Accessed October 19, 2026.

DailyMed - NEXLETOL (bempedoic acid) tablet, film coated. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=88d06d89-a3da-40b4-b273-8f4f7d56c4c9. Date Accessed October 19, 2026.