Nexlizet: Uses, Dosage, Side Effects & Precautions
Nexlizet is the first non-statin combined drug that the Food and Drug Administration (FDA) has approved (since 2020) for use as a backup treatment in adults who already take statins (a widely prescribed family of blood low-density lipoprotein (LDL) cholesterol-lowering drug) alongside diet and lifestyle changes. It combines two effective molecules – Bempedoic acid and ezetimibe—that help lower blood LDL cholesterol (bad cholesterol). This article will expound on the use, mode of action, dosage, administration, adverse effects, precautions, and drug interactions of Nexlizet.
What is Nexlizet Used for?
Your healthcare provider will prescribe you Nexlizet in two conditions:
- If you suffer from heterozygous familial hypercholesterolemia, an inherited gene disorder that causes an increase in blood concentrations of LDL cholesterol, have a heart disease that requires another drug to help lower your LDL cholesterol 2 Uses| Researched based study from National Institutes of Health.
- To date, Nexlizet is primarily used in adults.
Composition of Nexlizet
Nexlizet is a blend of two active molecules with different modes of action.
- Bempedoic Acid: Bempedoic acid blocks Adenosine Triphosphate-Citrate Lyase (ACL), a liver enzyme that is used to produce cholesterol in the body .
- Ezetimibe: Ezetimibe targets the Niemann-Pick C1-like 1 transporter, which permits the uptake of cholesterol at the level of the intestine. As a result, ezetimibe lowers blood cholesterol level by blocking its intestinal uptake .
This combination of actions makes Nexlizet very effective at lowering blood LDL cholesterol.
Dosage & Administration
Dosage & Administration of Nexlizet
- Nexlizet is given once daily and exists as blue oval-shaped tablets that contain 180 mg of bemepedoic acid and 10mg of ezetimibe .
- Taking Nexlizet with or without food will not affect its efficacy. However, make sure you swallow the drug whole.
- Your healthcare provider will assess your blood LDL cholesterol level within eight to twelve weeks of starting the drug, to ensure the drug is effective .
- Nexlizet is not an over-the-counter (OTC) drug and can be obtained only with your healthcare provider’s prescription.
- Keep Nexlizet in the original package, out of reach of children, and in a cool and dry place at room temperature (between 20 and 25 degrees centigrade) .
Nexlizet Side Effects
The adverse effects of Nexlizet may be due to either of its active molecules. If the symptoms worsen, your healthcare provider may consider to discontinue the drug.
Bempedoic acid: The adverse effects of Bempedoic acid include the following:
- Hyperuricemia: Bempedoic may cause gout in some patients (an increase in blood uric acid) . If you experience symptoms of gout such as intense pain, discomfort, swelling, and redness at joints (usually the big toe), seek medical assistance from your healthcare provider who may prescribe uric acid-lowering drugs if needed.
- Tendon rupture: Bempedoic acid may cause tendon rupture or tear. This usually occurs at the shoulder, the arm, or the heel. Adults more than 60 years old with kidney function impairment, prior tendon injury, or taking corticosteroids are more prone to tendon rupture1. Seek medical assistance if you experience symptoms of tendon disorders such as pain, swelling, tears, et cetera.
- Benign prostatic hyperplasia (BPH): Adult males taking Nexlizet may have an increase in the volume of their prostate. Contact your healthcare provider if you experience symptoms of BPH such as frequent or urgent need to pee (urinate), weak urine stream, being unable to fully empty the bladder, et cetera.
- Atrial fibrillation: Patients who have atrial fibrillation—a condition marked by an irregular heart rhythm—may experience an imbalance if they take Nexlizet. Whether to use Nexlizet or not in this condition will depend on your healthcare provider after he carefully weighs the benefits and risks.
- Upper Respiratory Tract Infection (URTI): The Bempedoic acid present in Nexlizet can cause a URTI in some patients, that may require medical intervention.
- Anemia: Patients receiving Bempedoic acid may experience a decrease in red blood cell count. However, this condition usually does not require medical intervention . Your healthcare provider will do some blood tests to check for anemia.
Other adverse effects of Bempedoic acid are alterations in kidney and liver function, pain in the extremities, abdominal pain, back pain, and abnormal muscle contractions.
Ezetimibe: The adverse effects of ezetimibe include the following:
- Alteration in liver function: Patients taking Nexlizet may experience a yellowing of the white of the eye (jaundice). Your doctor will regularly monitor your liver function tests to check for anomalies, such as an increase in liver enzymes.
- Diarrhea: Ezetimibe can cause you to have diarrhea. Drink lots of liquids and seek medical care or advice from your healthcare provider or pharmacist if the diarrhea persists or worsens.
- Abdominal pain: Patients receiving ezetimibe have commonly reported abdominal pain. Ezetimibe may affect your pancreas, which is found in the upper abdomen. The pains may be mild, moderate, or severe. If the pains persist, consult your healthcare provider.
Other adverse effects of ezetimibe are joint pain, dizziness, pain in the extremities, upper respiratory tract infection, and fatigue.
Warnings & Precautions for Nexlizet
Is Nexlizet safe?
Consider the following warnings and precautions if you are taking Nexlizet. These may require that your healthcare provider discontinue or adjust the dose of the drug. They include:
- Allergy: Some patients have had allergic reactions due to ezetimibe. These may manifest as a skin rash, body itching, sudden shortness of breath, et cetera. Do not use Nexlizet if you have been declared allergic to ezetimibe .
- Pregnancy: Nexlizet may harm the baby when given during pregnancy. Do not use if pregnant.
- Breastfeeding: Nexlizet is not advised if you are breastfeeding because it may pass into breast milk and harm the baby.
- Children: Research scientists do not yet know if Nexlizet is safe and effective in children . Do not use the drug on children without medical advice.
- Elderly: The adverse effects of Nexlizet in the elderly may be more severe than in young adults, even though there is no difference in safety and efficacy between them.
- Kidney impairment: In patients with mild to moderate kidney impairment, there is no need to adjust the dose of Nexlizet.
- Liver impairment: Nexlizet is not advised in patients with moderate to severe liver impairment . However, patients with mild liver impairment do not require the dose of the drug to be adjusted.
Drug Interactions With Nexlizet
Nexlizet can interact with several other drugs that can either increase the toxic effects or decrease the impact of Nexlizet.
- Simvastatin and Pravastatin: Taking Nexlizet and simvastatin or pravastatin at the same time can increase the blood concentration of the latter, leading to simvastatin- or pravastatin-related muscle disorders .
- Cyclosporine: The concomitant use of Nexlizet and cyclosporine may increase the blood concentrations of ezetimibe and cyclosporine. Patients receiving Nexlizet and cyclosporine at the same time may experience severe side effects from both drugs .
- Fibrates: The concomitant use of fibrates and ezetimibe may increase the excretion of cholesterol in bile, leading to the formation of gallstones. These drugs should not be used together.
- Cholestyramine: Cholestyramine is a drug that removes bile acids from your body, decreasing the concentration of ezetimibe found in Nexlizet, thus reducing its effect. You should consider taking Nexlizet two hours before or four hours after taking cholestyramine .
Key Takeaways for Nexlizet
- Nexlizet is an FDA-approved LDL cholesterol-lowering medicine that is used as a backup treatment in patients with heterozygous familial hypercholesterolemia already receiving a statin or who have a heart disease that requires further lowering of LDL cholesterol.
- Nexlizet is taken as a single dose per day, and its efficacy is not affected by food.
- Nexlizet has potential side effects that should be checked upon. Report to your healthcare provider if you notice any abnormal symptom.
- Do not use Nexlizet with other drugs without consulting your healthcare provider.