Nexlizet (bempedoic acid/ezetimibe) is a brand-name oral tablet that’s prescribed for high cholesterol. Nexlizet has interactions with some other drugs. Examples include simvastatin and cholestyramine.

Nexlizet is prescribed for certain adults to help reduce:

An interaction occurs when one substance causes another substance to have a different effect than expected.

To learn more about Nexlizet’s interactions, keep reading. For additional information about Nexlizet, including details about its uses, see this article.

Before you start treatment with Nexlizet, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Nexlizet interacts with supplements, herbs, or vitamins, see the “Nexlizet and other interactions” section below.)

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

Here’s a table of drugs that can interact with Nexlizet. Keep in mind that this table doesn’t include all drugs that may interact with Nexlizet. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Nexlizet
bile acid sequestrants• cholestyramine (Prevalite, Locholest)
• colesevelam (Welchol)
• colestipol (Colestid)
can make Nexlizet less effective
certain statinspravastatin
• simvastatin (Zocor, Flolipid)
can increase the risk of side effects of certain statins
fibrates• fenofibrate (Antara, Lipofen, others)
• choline fenofibrate (fenofibric acid, Trilipix)
• gemfibrozil (Lopid)
may increase risk of gallstones
corticosteroids• dexamethasone
methylprednisolone (Medrol)
• prednisone (Rayos)
may increase risk of tendon rupture
fluoroquinolone antibiotics• ciprofloxacin (Cipro)
• levofloxacin
• moxifloxacin (Avelox)
may increase risk of tendon rupture
cyclosporine (Neoral, others)can increase risk of side effects of cyclosporine and Nexlizet
warfarin (Jantoven)may increase risk of side effects of warfarin

In some cases, factors or conditions could prevent your doctor from prescribing Nexlizet due to the risk of harm. These are known as contraindications. The contraindications of Nexlizet include:

Having had an allergic reaction to Nexlizet or any of its ingredients

If you’ve had an allergic reaction to Nexlizet or any of its ingredients, your doctor will likely not prescribe Nexlizet. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Note: Before you start treatment with Nexlizet, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Nexlizet.

There aren’t any known interactions between Nexlizet and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Nexlizet treatment.

This is because drinking large amounts of alcohol can cause liver damage. And Nexlizet may cause increased liver enzymes as a side effect.* Increased liver enzymes can be a sign of liver damage. So drinking alcohol during Nexlizet treatment may increase your risk of liver problems.

If you have questions about drinking alcohol while taking Nexlizet, talk with your doctor.

* For details about Nexlizet’s side effects, see this article.

Here’s a closer look at certain drug interactions of Nexlizet.

Certain statins

Nexlizet can interact with certain statin drugs, which are drugs used to help lower cholesterol levels. Your doctor may prescribe Nexlizet with a statin.

Interaction result: Taking Nexlizet with simvastatin (Zocor, Flolipid) or pravastatin can increase the risk of side effects of these statins. In particular, it can raise the risk of muscle problems with these drugs.

Interaction explained: Nexlizet can increase the level of simvastatin or pravastatin in your blood. Having a higher level of these drugs in your blood is more likely to cause side effects.

Steps you or your doctor may take: If you take Nexlizet with simvastatin, your doctor typically won’t prescribe a simvastatin dosage that’s higher than 20 milligrams (mg) per day. If you take Nexlizet with pravastatin, your doctor typically won’t prescribe a pravastatin dose that’s higher than 40 mg per day.

If you take Nexlizet with either of these statins, tell your doctor right away if you have any muscle pain or weakness.

If you have questions about taking Nexlizet with a statin, talk with your doctor or pharmacist.

Bile acid sequestrants

Nexlizet can interact with bile acid sequestrants, which are another group of drugs used to help lower cholesterol levels.

Interaction result: Taking Nexlizet at the same time of day as a bile acid sequestrant can make Nexlizet less effective.

Interaction explained: Nexlizet contains two active drugs, ezetimibe and bempedoic acid. If you take Nexlizet with a bile acid sequestrant, the bile acid sequestrant can attach to the ezetimibe in your digestive system. This can reduce the amount of ezetimibe that your body absorbs. As a result, Nexlizet will be less effective at lowering your cholesterol.

Examples of bile acid sequestrant drugs: Here are some bile acid sequestrants that may interact with Nexlizet:

  • cholestyramine (Prevalite, Locholest)
  • colesevelam (Welchol)
  • colestipol (Colestid)

Steps you or your doctor may take: If your doctor prescribes Nexlizet with a bile acid sequestrant, you should take these drugs at different times of day to prevent this interaction. You should take your dose of Nexlizet at least 2 hours before or at least 4 hours after taking your dose of bile acid sequestrant.

If you have questions about taking Nexlizet with a bile acid sequestrant, talk with your doctor or pharmacist.

Fibrates

Nexlizet can interact with fibrates, which are another group of drugs used to help lower cholesterol levels.

Interaction result: Taking Nexlizet with a fibrate drug can raise your risk of gallstones.

Interaction explained: Nexlizet and fibrates both increase the amount of cholesterol that passes into your bile. Bile is stored in your gallbladder. If there is too much cholesterol in your bile, gallstones can form in your gallbladder.

Examples of fibrate drugs: Here are some fibrate drugs that may interact with Nexlizet:

  • fenofibrate (Lipofen, Antara, others)
  • choline fenofibrate (fenofibric acid, Trilipix)
  • gemfibrozil (Lopid)

Steps you or your doctor may take: If your doctor prescribes Nexlizet with a fibrate, they’ll typically prescribe fenofibrate, as this may be safer to use with Nexlizet than other fibrates.

If you take Nexlizet with a fibrate drug, see your doctor if you develop symptoms of gallstones. These can include sudden and worsening pain just below your ribs, between your shoulder blades, or in your right shoulder, as well as nausea, vomiting, sweating, and restlessness.

If you have questions about taking Nexlizet with a fibrate drug, talk with your doctor or pharmacist.

Nexlizet may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Nexlizet.

Nexlizet interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Nexlizet and herbs

There are no specific reports of herbs interacting with Nexlizet. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Nexlizet treatment.

Nexlizet and vitamins

There are no specific reports of vitamins interacting with Nexlizet. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Nexlizet.

Nexlizet and food

There were no reports of food interactions with Nexlizet. If you’d like to learn more about eating certain foods during treatment with Nexlizet, talk with your doctor.

Nexlizet and vaccines

There aren’t any known interactions between Nexlizet and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Nexlizet and lab tests

Nexlizet isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

NEXLIZET INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Nexlizet. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Nexlizet. The impact of cannabis may affect how well you stick to your Nexlizet treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Nexlizet. Before you take this drug, be sure to talk with your doctor about your health history. Nexlizet may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Nexlizet include:

  • Past tendon disorders: Nexlizet can raise your risk of tendon injury, such as tendon rupture (tear). If you’ve had past tendon disorders, you may have a higher risk of this side effect, especially if you are age 60 years or older or have kidney failure. Talk with your doctor about whether Nexlizet is right for you. Other treatments may be better choices for you.
  • Kidney problems: If you have kidney problems, Nexlizet may make them worse. If you have kidney failure, you may also have a raised risk of tendon rupture with Nexlizet (see just above), especially if you are age 60 years or older. Talk with your doctor about whether Nexlizet is right for you. They may recommend other treatments that are better choices for you.
  • Liver problems: If you have liver problems, Nexlizet could make these worse. Talk with your doctor about whether Nexlizet is right for you. If you have severe liver problems, your doctor will likely recommend a treatment other than Nexlizet.
  • History of gout: Nexlizet can increase the level of uric acid in your blood, which can raise your risk of gout. If you have a history of gout, talk with your doctor about whether Nexlizet is right for you.
  • Allergic reaction: If you’ve had an allergic reaction to Nexlizet or any of its ingredients, your doctor will likely not prescribe Nexlizet. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
  • Breastfeeding: It’s not known whether it’s safe to take Nexlizet while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk. However, because of the way the drug works, it may be harmful to a child who is breastfed. Your doctor will likely recommend that you don’t breastfeed while taking Nexlizet. If you’re breastfeeding or planning to, talk with your doctor before taking Nexlizet. They can talk with you about treatment options and ways to feed your child.
  • Pregnancy: There haven’t been enough clinical trials to determine whether Nexlizet is safe to take while pregnant. However, because of the way the drug works, it may be harmful to a developing fetus. If you’re pregnant or planning to become pregnant, tell your doctor before starting Nexlizet. They can advise you on the right treatment plan for you.

You can take certain steps to help prevent interactions with Nexlizet. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or use cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Nexlizet label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Nexlizet doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Nexlizet by taking it exactly as your doctor prescribes.

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.