Nexletol is a brand-name prescription drug. It’s a type of drug called an adenosine triphosphate-citrate lyase inhibitor and contains the active drug bempedoic acid. It comes as a tablet and is taken by mouth.
Nexletol is approved by the Food and Drug Administration (FDA) to lower cholesterol in certain adults.
Similar to other drugs, Nexletol may cause side effects. Read below for information about possible side effects, including common, mild, and serious ones.
For a general overview of Nexletol, including details about its uses, see this article.
If you’d like to take Nexletol, search here to find a healthcare professional who might prescribe it.
Some of Nexletol’s side effects may be more common than others. These side effects may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about any side effects with Nexletol.
In clinical studies of Nexletol, these were some side effects that occurred more often:
- back pain
- abdominal pain or discomfort
- muscle spasms
- anemia (low red blood cell level)*
- upper respiratory tract infection*
* For more information about this side effect, see “Nexletol: Side effects explained” below.
Nexletol can cause mild side effects, which are listed below. However, this list doesn’t include all possible mild side effects. To learn more about Nexletol’s side effects, view the drug’s prescribing information.
Nexletol’s mild side effects include:
- back pain
- abdominal pain or discomfort
- bronchitis
- increased liver enzyme levels
- muscle spasms
- pain in extremities (feet, hands, or limbs)
- anemia (low red blood cell level)*
- upper respiratory tract infection*
The side effects listed above may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about side effects with Nexletol.
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 about this side effect, see “Nexletol: Side effects explained” below.
It’s possible to have serious side effects with Nexletol. Serious side effects are listed below, but this list may not include all possibilities. To learn more about Nexletol’s side effects, view the drug’s prescribing information.
Call your doctor right away if you have serious side effects with Nexletol. However, if you think you’re having a medical emergency or have life threatening side effects, call 911 or your local emergency number.
Serious side effects of Nexletol and their possible symptoms include:
- Benign prostatic hyperplasia (enlargement of the prostate gland). Symptoms can include:
- dribbling at the end of urination
- need to urinate frequently at night
- painful urination
- urine leakage
- weak or slowed urinary stream
- Tendon rupture.*
- High uric acid levels and gout.*
- Atrial fibrillation (a type of irregular heart rhythm).*
- Allergic reaction.†
* For more information about this side effect, see “Nexletol: Side effects explained” below.
† An allergic reaction is possible after taking Nexletol. However, this side effect was not reported in clinical studies.
Here are some common questions about the drug’s side effects and answers to them. Talk with your doctor if you have other questions about this drug.
Are side effects of Nexletol 180-mg doses different from those of other doses?
That’s not known for sure because there is only one recommended dosage for Nexletol. It’s 180 milligrams (mg) once per day.
It’s possible that other medications used to lower cholesterol, including atorvastatin (Lipitor), may have certain side effects that vary with different dosages. However, this doesn’t apply to Nexletol.
Talk with your doctor or pharmacist if you have questions about side effects with Nexletol.
Would my risk of having side effects from Nexletol increase if I took other medications with it?
Possibly. Clinical studies didn’t compare side effects from Nexletol in combination with other medications to those of Nexletol alone.
However, it’s possible that taking Nexletol with certain other cholesterol-lowering medications may increase the risk of side effects if the medications share similar ones. It’s worth noting that other cholesterol-lowering medications such as statins usually have more side effects than Nexletol.
Examples of these medications include simvastatin (Zocor) and pravastatin (Pravachol). Nexletol’s manufacturer does not recommend taking Nexletol with either of these medications. Doing so can increase your risk of having side effects from Zocor or Pravachol.
It’s important to tell your doctor all the medications you take. They’ll help you decide if Nexletol is safe to use with your other medications.
Is fatigue a side effect of Nexletol?
Fatigue is not a known side effect of Nexletol. However, it may be a symptom of other Nexletol side effects.
For example, fatigue may be a symptom of atrial fibrillation, anemia, or respiratory infections. These are potential side effects of Nexletol.
Tell your doctor if you have bothersome fatigue while you’re taking Nexletol.
If you have fatigue in combination with chest pain, heart palpitations, or rapid heartbeat, call your doctor immediately. This may be a sign of atrial fibrillation, which is a medical emergency.
Here’s detailed information about some of Nexletol’s side effects.
Tendon rupture
Tendon rupture was a rare side effect reported in clinical studies of people taking Nexletol. Tendons are strong, flexible tissues that connect muscles to bones.
This side effect can occur in any tendon, but the following tendons were most commonly affected during clinical studies:
- Achilles tendon, which is located behind the ankle
- bicep tendon, which is located in the upper arm
- rotator cuff, which is located in the shoulder
Symptoms of tendon rupture can include:
- inability to put weight on the affected joint
- pain in the affected area
- snapping or popping sound of tendon
- swelling or bruising in the affected area
- weakness in the affected joint
Tendon rupture can happen within weeks to months of starting Nexletol treatment.
You may have an increased risk of having a ruptured tendon while taking Nexletol if:
- you’re ages 60 years or older
- you take steroid medications
- you take certain antibiotics, such as ciprofloxacin (Cipro) or levofloxacin (Levaquin)
- you have kidney failure
- you have had tendon problems in the past
What to do
Let your doctor know right away if you experience symptoms of tendon rupture. They’ll likely have you stop taking Nexletol.
Rest the joint with the affected tendon and follow your doctor’s advice for healing the tendon.
Anemia
Anemia was commonly reported in clinical studies of people taking Nexletol. Anemia is a decrease in your body’s production of red blood cells.
Most people who had anemia in clinical studies did not have symptoms. However, you may have some symptoms if you develop anemia while taking Nexletol.
Symptoms of anemia typically include:
- dizziness
- fainting
- fatigue
- headache
- pale skin
- shortness of breath
- weakness
What to do
Let your doctor know if you have symptoms of anemia. They’ll likely check your red blood cell levels using a blood test.
If you have anemia, your doctor may recommend taking iron or vitamin supplements. You can also eat foods that may help your body make more red blood cells. These include:
- eggs
- fish
- leafy greens
- meat
High uric acid level
High uric acid level was a common side effect in clinical studies of people taking Nexletol.
Uric acid is a natural waste chemical that your body produces after digesting certain foods. Typically, your kidneys filter uric acid out through your urine. However, if your kidneys can’t get rid of uric acid fast enough, it builds up in your blood.
High uric acid levels in your blood can lead to gout. Gout happens when uric acid crystals build up in certain joints. Symptoms can include:
- burning and redness around the affected joint
- intense and sudden pain in the affected joint
- swelling of the affected joint
- warmth in the affected area
What to do
Let your doctor know if you have gout symptoms while taking Nexletol. They’ll check your uric acid levels and prescribe medication to lower them if necessary. They may also prescribe medication to help relieve your gout symptoms.
Upper respiratory tract infection
Upper respiratory tract infection was commonly reported in clinical studies of people taking Nexletol.
An upper respiratory tract infection is similar to the common cold. It typically affects your nose, throat, sinuses, windpipe, or bronchi (the airways that connect your windpipe to your lungs).
Symptoms include:
- cough
- headache
- nose congestion
- sinus pressure
- sneezing
- sore throat
What to do
Upper respiratory tract infections typically go away without antibiotic (drugs that kill bacteria) treatment. However, certain over-the-counter (OTC) medications may help relieve your symptoms.
Your doctor or pharmacist can help you choose OTC medications to treat your symptoms. They’ll also let you know if OTC preparations interact with other medications you take or conditions you have. If your symptoms are severe, your doctor can prescribe medication to help relieve your symptoms.
Atrial fibrillation
Atrial fibrillation is a rare side effect reported in clinical studies of people taking Nexletol. Atrial fibrillation is a condition in which your heart beats irregularly. The top part of the heart flutters, and it can’t pump enough blood into the lower part of the heart.
Symptoms of atrial fibrillation include:
- chest pain
- dizziness
- fainting
- fatigue
- heart palpitations
- rapid heartbeat
- shortness of breath
- weakness
What to do
Seek emergency medical attention if you experience chest pain or other symptoms of atrial fibrillation.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Nexletol. A more severe allergic reaction is rare but possible.
An allergic reaction is possible after taking Nexletol. However, this side effect was not reported in clinical studies.
Possible symptoms of mild and serious allergic reactions are listed in the table below.
| Mild allergic reaction symptoms | Serious allergic reaction symptoms |
| • itching | • trouble breathing |
| • rash | • swelling in your throat or mouth |
| • flushing | • swelling under your skin, possibly in your hands, feet, lips, or eyelids |
If you have an allergic reaction to Nexletol, call your doctor right away. This is important to do because the reaction could become severe.
However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a 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 option if you have certain medical conditions or other factors that affect your health.
The conditions and factors to consider include those described below.
Kidney problems. Your risk of having certain side effects from Nexletol may be higher if you have kidney problems. Before you start taking Nexletol, let your doctor know if you have kidney problems. They’ll let you know whether Nexletol is safe for you to take.
High uric acid levels. Nexletol can increase uric acid levels in your blood. This can lead to gout. Before you start taking Nexletol, let your doctor know if you have had high uric acid levels or gout in the past. They’ll likely check your uric acid levels regularly while you’re taking Nexletol.
Tendon rupture. Tendon rupture can happen while you’re taking Nexletol. Your risk of having this side effect is higher if you’ve had tendon problems in the past. Due to this risk, doctors will likely not prescribe Nexletol if you’ve had tendon problems.
Allergic reaction. If you’ve had an allergic reaction to Nexletol or any of its ingredients, your doctor will likely not prescribe Nexletol. Ask your doctor what other medications may be better options for you.
Consuming alcohol during Nexletol treatment
There are no known interactions between Nexletol and alcohol. However, drinking large amounts of alcohol can affect your liver. You may have an increased risk of certain side effects from Nexletol, such as high liver enzyme levels, if you have liver damage due to drinking excess alcohol.
Tell your doctor if you drink alcohol. They’ll let you know how much alcohol, if any, is safe to drink while taking Nexletol.
Pregnancy and breastfeeding during Nexletol treatment
There is not enough research to know whether Nexletol is safe to take during pregnancy. However, scientists believe that Nexletol may cause harm to a fetus based on how it works. Due to this risk, doctors typically will not prescribe Nexletol for people who are pregnant.
If you become pregnant while taking Nexletol, let your doctor know right away. They may have you stop taking this medication during your pregnancy.
You should not breastfeed while taking Nexletol. Although Nexletol has not been tested in people who are breastfeeding, it’s believed Nexletol may cause harm to a breastfeeding child based on how the drug works.
Talk with your doctor or pharmacist for additional information about Nexletol. If you have questions about the drug’s side effects, your pharmacist or healthcare professional can help answer them.
In addition to discussing Nexletol with your doctor, you may find the following articles helpful in learning more.
- Overview of Nexletol. To read an overview of Nexletol, see this article.
- Drug comparison. To learn how Nexletol compares with Repatha, read this article.
- Details about high cholesterol. To learn more about high cholesterol, which Nexletol is used to treat, see this article.
Disclaimer: Healthgrades 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.