Bempedoic acid
Metabolic Health · ACL inhibitor
Also known as: Nexletol
Tier B-
Bottom line
Read Off Label grades Bempedoic acid as B- (5.9/10) based on moderate-strong evidence, moderate benefit magnitude, and a med-risk safety profile.
CLEAR Outcomes 2023 finally gave statin-intolerant patients a non-statin oral with CV outcome data.
Typical use: 180 mg PO daily — Rx.
What this is
CLEAR Outcomes 2023 finally gave statin-intolerant patients a non-statin oral with CV outcome data. Gout flares are a real side effect — screen for baseline uric acid. Expensive relative to ezetimibe with similar LDL reduction.
Mechanism
ATP-citrate lyase inhibitor; blocks cholesterol synthesis upstream of HMG-CoA reductase; prodrug activated only in liver (bypasses muscle → less myalgia); ~20% LDL reduction monotherapy; CLEAR Outcomes trial showed CV benefit
Dose & route
180 mg PO daily
Citations
- https://pubmed.ncbi.nlm.nih.gov/36876740/
- https://pubmed.ncbi.nlm.nih.gov/30415637/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7034386/
- https://clinicaltrials.gov/study/NCT02988115
- https://europepmc.org/article/PMC/13101281
Links go to the source. If a link is dead or you want something re-checked, let me know.
Common questions
- Does Bempedoic acid work?
- Read Off Label rates the evidence for Bempedoic acid as Moderate-Strong and the benefit magnitude as moderate, producing an overall grade of B- (5.9/10). CLEAR Outcomes 2023 finally gave statin-intolerant patients a non-statin oral with CV outcome data.
- Is Bempedoic acid safe?
- Bempedoic acid has a med risk profile in published human data. Legal status: Rx (Nexletol; combo with ezetimibe = Nexlizet). This is not medical advice — see the disclaimer.
- What is the typical dose for Bempedoic acid?
- 180 mg PO daily
- How does Bempedoic acid work?
- ATP-citrate lyase inhibitor; blocks cholesterol synthesis upstream of HMG-CoA reductase; prodrug activated only in liver (bypasses muscle → less myalgia); ~20% LDL reduction monotherapy; CLEAR Outcomes trial showed CV benefit
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.