bempedoic acid + ezetimibe at a glance
Medicine class
ATP-citrate lyase inhibitor combined with a cholesterol-absorption inhibitor
Main role
Lowers LDL cholesterol in adults with primary hypercholesterolaemia, mixed dyslipidaemia or relevant cardiovascular risk
Taking the tablet
Swallow whole, with or without food
Age group
Licensed for adults; safety and efficacy under 18 years have not been established
What is bempedoic acid + ezetimibe used for?
Licensed uses in adults, alongside diet and management of other cardiovascular risk factors where relevant:
Primary hypercholesterolaemia or mixed dyslipidaemia when LDL cholesterol remains inadequately controlled with tolerated treatment.
Treatment without a statin when statins are contraindicated or not tolerated and ezetimibe alone has not provided adequate control.
Replacement of bempedoic acid and ezetimibe already taken separately.
Reducing cardiovascular risk through LDL-cholesterol lowering in adults with established or high risk of atherosclerotic cardiovascular disease whose treatment remains inadequate.
How does bempedoic acid + ezetimibe work?
Bempedoic acid acts mainly in the liver to reduce cholesterol production and increase LDL-receptor activity. Ezetimibe reduces cholesterol absorption from the small intestine. Together they lower circulating LDL cholesterol.
bempedoic acid + ezetimibe preparations and strengths
Tablet
Route: Oral
Strengths: 180 mg + 10 mg
How to take bempedoic acid + ezetimibe
Follow the prescription label. Swallow the film-coated tablet whole, with or without food. Bile-acid sequestrants such as cholestyramine can reduce ezetimibe absorption and should not be taken at the same time; ask a pharmacist or prescriber about spacing.
Do not crush or split the tablet unless specifically advised.
Do not stop treatment without discussing it with the prescriber, because cholesterol may rise again.
bempedoic acid + ezetimibe side effects
Common or expected effects
- Raised uric acid or gout
- Constipation, diarrhoea, abdominal pain, nausea or wind
- Headache or dizziness
- Muscle spasms, muscle or joint pain, back pain or limb pain
- Tiredness or weakness
- Anaemia or reduced haemoglobin
- Changes in liver or kidney blood-test results
- Cough or raised blood pressure
Get urgent medical advice
- Serious allergic reaction, including facial or throat swelling and breathing difficulty
- Severe muscle injury, particularly when used with a statin
- Hepatitis or other significant liver problems
- Gallstones, gallbladder inflammation or pancreatitis
- Reduced platelets causing unusual bruising or bleeding
bempedoic acid + ezetimibe in pregnancy
This combination is contraindicated during pregnancy. Effective contraception is advised during treatment. Anyone planning pregnancy or becoming pregnant should contact the prescriber promptly so treatment can be changed.
bempedoic acid + ezetimibe while breastfeeding
Very small amounts of both components have been detected in human milk. Use during breastfeeding may be considered only after a clinician weighs the treatment benefit against breastfeeding benefits, because information about effects on breastfed infants is limited.
bempedoic acid + ezetimibe interactions
Important interactions include:
Statins, especially simvastatin
Bempedoic acid can increase statin exposure and muscle-injury risk. The prescriber must check whether the statin combination is permitted; unexplained muscle symptoms need prompt review.
Bile-acid sequestrants, including cholestyramine
They reduce ezetimibe exposure and may weaken cholesterol lowering, so administration must be separated.
Fibrates
The combination may alter triglycerides and HDL cholesterol and increase the risks of anaemia, raised uric acid or gallstones.
Common questions about bempedoic acid + ezetimibe
Answers are fully visible for fast scanning and source review.
Is bempedoic acid + ezetimibe a statin?
No. It combines an ATP-citrate lyase inhibitor with a cholesterol-absorption inhibitor, although it may be prescribed alongside a statin.
Can it be taken with a statin?
Yes, in suitable adults, but it can increase statin exposure and muscle-related adverse effects. The prescriber must review the statin combination.
Why are the two ingredients combined?
They target different pathways: bempedoic acid reduces liver cholesterol production while ezetimibe reduces intestinal absorption.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.