Uses

Indicated as an adjunct to diet and exercise to reduce LDL-cholesterol in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia. Also reduces the risk of major adverse cardiovascular events in adults unable to tolerate recommended statin therapy.

Do not use if

Contraindicated in patients with known hypersensitivity to bempedoic acid or any excipients. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported.

Side effects

Common side effects include upper respiratory tract infections, muscle spasms, hyperuricemia, and back pain. Tendon rupture is a rare but serious adverse effect. Elevated liver enzymes and new-onset atrial fibrillation have been reported.

Warnings

Monitor serum uric acid periodically; initiate urate-lowering therapy if hyperuricemia or gout develops. Risk of tendon rupture, particularly in patients also taking fluoroquinolones or corticosteroids. Perform liver function tests as clinically indicated.

How it works

Bempedoic acid is an ATP-citrate lyase (ACL) inhibitor that is converted to its active form by very-long-chain acyl-CoA synthetase 1 (ACSVL1), active only in the liver. By inhibiting ACL, it reduces cholesterol synthesis in hepatocytes, upregulates LDL receptors, and lowers plasma LDL-C without affecting skeletal muscle, reducing myopathy risk.

Storage

Store at controlled room temperature 20–25°C (68–77°F); excursions permitted to 15–30°C. Store in original package to protect from moisture.