Nexletol (bempedoic acid) is a prescription brand-name medication. It’s approved by the Food and Drug Administration (FDA) to lower levels of low-density lipoprotein (LDL) cholesterol, commonly known as “bad” cholesterol. The drug is approved for use in certain adults with:

Here are some fast facts on Nexletol:

  • Active ingredient: bempedoic acid
  • Drug class: adenosine triphosphate-citrate lyase inhibitor
  • Drug form: oral tablet
  • FDA approval year: 2020

As with other drugs, Nexletol can cause some side effects. Keep reading to learn about possible common, mild, and serious side effects. For a comprehensive look at Nexletol, including details about its uses, see this article.

Nexletol can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Nexletol in clinical trials:

Mild side effects can occur with Nexletol use. This list doesn’t include all possible mild side effects reported with the drug. For more information, you can refer to the Nexletol patient information.

Mild side effects of Nexletol can include:

These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Nexletol and want to tell the FDA about it, visit MedWatch.

* For more information on this side effect, see the “Side effect specifics” section below.

Nexletol may cause serious side effects, although these were rare in clinical trials. The list below may not include all possible reported serious side effects of the drug. For more information, you can refer to the Nexletol package instructions.

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.

Serious side effects* can include:

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

Nexletol may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Are Nexletol’s side effects similar to those of other cholesterol medications?

Nexletol can cause some side effects that are similar to those of other cholesterol medications. But Nexletol can cause some different side effects as well. Also, some side effects caused by other cholesterol medications weren’t reported in people taking Nexletol in clinical trials.

For example, some cholesterol medications may cause myopathy (muscle pain and weakness). But myopathy wasn’t reported as a side effect by people taking Nexletol in these trials.

People taking Nexletol in clinical trials did report pain in their shoulders, legs, and arms. And, like some other cholesterol medications, Nexletol may cause liver damage.

To learn more about possible side effects of Nexletol, talk with your doctor or pharmacist.

Can Nexletol damage my liver?

Nexletol can affect your liver, but it’s very unlikely to cause liver damage.

Some people who took Nexletol in clinical trials had increased levels of liver enzymes as a side effect. High levels of liver enzymes can be a sign that your liver isn’t working as well as it should. For most people who had this side effect, their liver enzyme levels returned to normal over time, including people who continued taking Nexletol. But some people did have to stop taking the drug before their liver enzymes returned to normal.

Most people who had high levels of liver enzymes didn’t report any symptoms. And it doesn’t appear that anyone who had this side effect in clinical trials experienced liver damage. But that doesn’t mean it can’t happen.

To learn more, see the “Side effect specifics” section below. If you’re concerned about how Nexletol can affect your liver, talk with your doctor.

I heard Nexletol can cause ruptured tendons. Is it safe for me to exercise while taking Nexletol?

Maybe, but first talk with your doctor before exercising. Nexletol can cause tendon problems, including tendon ruptures (tears). Tendons are a type of tissue that connects your muscles to your bones.

The tendon problems are most likely to occur around the shoulder, arm, or back of the ankle (Achilles tendon). But the problems can occur in any tendon in your body.

If you’re working out and notice a tendon problem, stop exercising. Be sure to talk with your doctor or get urgent medical help. You’ll likely need to stop taking Nexletol after speaking with your doctor or receiving emergency care. Your doctor may recommend a different medication for your condition.

If you’re thinking about starting an exercise program while using Nexletol, talk with your doctor. They can help assess your risk for tendon rupture and make safe exercise suggestions.

To learn if you may have a higher risk than usual for tendon problems from Nexletol, see the “Side effect specifics” section below.

Can Nexletol decrease my risk for heart problems?

Possibly. It’s not known if Nexletol can decrease the risk of heart problems or death due to high cholesterol. This wasn’t evaluated in clinical studies. Talk with your doctor if you’re concerned about your risk for heart problems due to your high cholesterol.

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

Increased liver enzyme levels

Nexletol use could cause increased levels of liver enzymes. This side effect wasn’t one of the more common side effects reported in people taking Nexletol in clinical trials. And most people who reported it had only a mild increase.

Sometimes increased liver enzyme levels are a sign that your liver isn’t working as well as it should. Most people who had this side effect while taking Nexletol didn’t develop any symptoms of liver problems, such as liver failure or hepatitis. Liver enzyme levels returned to normal for some people as they continued to take Nexletol. But some people did have to stop taking the drug for their levels to return to normal.

What you can do

Increases in liver enzyme levels usually don’t cause symptoms. Instead, you likely won’t experience symptoms unless a more severe liver condition, such as hepatitis, is causing the elevations.

While taking Nexletol, your doctor will monitor your liver enzyme levels by ordering blood tests. If they notice a small increase, they may have you continue taking the medication. But if the increase is large, your doctor may have you stop taking Nexletol, at least for a little while. They can review the best treatment options for you.

Ruptured tendon

Although rare, Nexletol can cause tendon ruptures (tears). Tendons are thick tissues that connect your muscles to bones.

The tendon problems are most likely to occur around the shoulder, arm, or back of the ankle (Achilles tendon). But the problems can occur in any tendon in your body. This side effect is more likely to happen during the first few weeks after beginning treatment with Nexletol. But in clinical trials, tendon problems also occurred within weeks or months of starting to use Nexletol.

You may be at a higher risk for ruptured tendon while taking Nexletol if you:

What you can do

While you use Nexletol, watch for any symptoms of a ruptured tendon, including:

  • hearing or feeling a pop in a tendon
  • bruising around the tendon
  • being unable to move or place weight on the affected area

If you notice any of the above symptoms, stop taking Nexletol right away and talk with your doctor or get urgent medical help. Your doctor may recommend a different medication for your condition.

High uric acid level

Nexletol can cause hyperuricemia (a high level of uric acid in the blood), which can result in gout. Gout is a condition that causes sudden, painful swelling in your joints.

Hyperuricemia usually occurs within the first 4 weeks of beginning treatment with Nexletol. If you already have gout, you may be at higher risk for this side effect.

What you can do

Be on the lookout for sudden pain, redness, or swelling in your joints while taking Nexletol. Your doctor will also order blood tests to monitor your blood uric acid levels. They may decide to prescribe medication to decrease your uric acid level.

Pain

Pain is a side effect that may occur with Nexletol. It can occur in the back, belly, shoulders, legs, and arms. This side effect was more common than other side effects of Nexletol. But pain didn’t occur in many people in clinical trials.

What you can do

Talk with your doctor if you experience pain while taking Nexletol. They can recommend ways to treat this side effect. If the pain is bothersome to you, they may recommend a different medication for your condition.

Anemia

Anemia (low levels of red blood cells) can occur with Nexletol use. But this side effect wasn’t as common as some other side effects of the drug in clinical trials. Most people who had anemia in the trials didn’t develop symptoms or require treatment.

What you can do

You can watch for symptoms of anemia while taking Nexletol, including:

  • feeling like you have less energy than usual
  • weakness
  • dizziness
  • shortness of breath

Talk with your doctor if you notice the above symptoms. During your Nexletol treatment, they may order blood tests to monitor your red blood cell counts.

Allergic reaction

As with most drugs, Nexletol can cause an allergic reaction in some people. But this side effect wasn’t reported in clinical studies.

Symptoms can be mild or serious and can include:

  • rash
  • itching
  • flushing (warmth or redness/deepening of skin color for a brief time)
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Nexletol. But if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you take Nexletol. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Tendon problems. Nexletol can cause ruptured tendons as a side effect. This side effect is rare, but your risk may be higher if you have tendon problems or a history of tendon problems. Your doctor may decide to recommend a different treatment if this applies to you.

Liver problems. Nexletol may cause increases in your liver enzyme levels. This can be a sign of liver damage or that your liver isn’t working properly. Talk with your doctor about whether it’s safe to take Nexletol with your liver problems.

Kidney problems. Ruptured tendons can occur with Nexletol use. If you have kidney problems, such as kidney failure, you may be at higher risk than usual for this side effect. Talk with your doctor about whether it’s safe to take Nexletol with your kidney problems.

Gout. Nexletol can increase levels of uric acid in the blood, which can lead to gout. If you have gout, you may be at higher risk for this side effect than usual. Before you start treatment with Nexletol, be sure to talk with your doctor if you have a history of gout.

Allergic reaction. You shouldn’t take Nexletol If you’ve ever had an allergic reaction to Nexletol or any of its ingredients. Talk with your doctor about what other treatments are better choices for you.

Alcohol use with Nexletol

There aren’t known interactions between taking Nexletol and drinking alcohol.

However, excessive drinking can harm your liver. And Nexletol can cause increases in your liver enzyme levels. This can be a sign of liver problems. (To learn more, see the “Side effect specifics” section above.)

Be sure to talk with your doctor before consuming alcohol while you’re taking Nexletol. They can help determine how much alcohol, if any, is safe for you to drink while using the drug.

Pregnancy and breastfeeding while taking Nexletol

Here’s some information whether you can use Nexletol while pregnant or breastfeeding.

Pregnancy. Nexletol hasn’t been studied during pregnancy, so it isn’t known if it’s safe to take the drug while pregnant. Because of this, you should call your doctor right away if you become pregnant while taking Nexletol.

If you’re pregnant or planning to become pregnant, talk with your doctor before you use Nexletol. They can advise you on whether the drug is right for you.

Breastfeeding. You shouldn’t breastfeed while taking Nexletol. It isn’t known whether the drug shows up in human breast milk. It’s believed, based on how the drug works, that Nexletol could cause serious side effects in a child who is breastfed. Talk with your doctor about treatment options other than Nexletol if you plan on breastfeeding.

Side effects from Nexletol aren’t common. And when they do occur, they’re usually mild. Most mild side effects of the drug go away with time and don’t require medical attention.

Nexletol can rarely cause serious side effects.* You should talk with your doctor if you experience symptoms of:

You should also talk with your doctor if you become pregnant while taking Nexletol.

If you’d like to learn more about Nexletol, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Note: For more information on high cholesterol, see our list of cholesterol-related articles.

* To learn more about the side effects in this list, see the “Side effect specifics” section above.

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 other 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.