Bempedoic Acid Pharmacology Podcast

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 13 April 2023

⏱️ 12 minutes

🔗️ Recording | iTunes | RSS

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Summary

Bempedoic acid, also known as Nexletol, is a once-daily medication used in lipid management. I discuss its pharmacology, side effects, and much more on this podcast episode.

Bempedoic is a once-daily medication that doesn’t need to be titrated. Standard dosing is 180mg once daily which can be taken with or without food.

What are the most common side effects of bempedoic acid? One of the most notable adverse effects is hyperuricemia. This is usually seen within the first 4 weeks of being on the medication but could happen throughout the treatment.

Tendon problems can happen as well, especially in patients who are greater than 60 years old, on fluoroquinolones, have renal failure, or are taking corticosteroids.

If Bempedoic acid is taken along with Simvastatin, it is recommended to avoid doses greater than 20mg. This is partly because Bempedoic Acid 180mg along with 40mg of Simvastatin was found to increase Simvastatin AUC by 2-fold. The mechanism of this interaction has yet to be reported. Pravastatin doses greater than 40mg are to be avoided as well due to an increased risk of myopathy. Atorvastatin and Rosuvastatin didn’t have any maximum dose considerations.

Transcript

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0:00.0	Hey all, welcome back to the Real Life Pharmacology podcast. I'm your host pharmacist Eric Christensen.
0:05.7	Thank you so much for listening today. As always, go check out Real Life Pharmacology.com.
0:12.3	Go get your free 31 page PDF on the top 200 drugs. If you enjoy this podcast, you're definitely going to enjoy the content and Pharmacology flashcards so you can find those on Amazon.
0:25.4	Great resource for any student taking board exams or if you just want a little refresher out in clinical practice.
0:32.5	Good for nursing, pharmacy obviously, as well as med students. So again, flipping pharmacology flashcards,
0:40.4	you can go find those on Amazon. All right, so the drug of the day today is Bempidoic acid.
0:47.8	Brand name of this medication is Nexletal, and this medication is a newer class, relatively newer class of antilipid agents. So lipid
0:59.8	lowering therapy. Mechanistically, how does this drug work? Well, it inhibits adenosine triphosphate
1:08.9	citrate lyase. So that is a big mouthful for sure. This enzyme is
1:17.1	abbreviated ACL. So with that enzyme, that enzyme plays an important role in the pathway of cholesterol biosynthesis. So naturally, if we
1:32.4	inhibit the function of this enzyme, we're going to produce less cholesterol, ultimately lowering
1:40.5	LDL levels is our primary goal there. And this drug certainly does that.
1:47.8	So where are we going to see this medication use?
1:50.9	So I've got to be honest, I have not seen it more than once or twice in practice so far.
1:57.8	It's been out a few years here, a couple of years anyway, after it was approved by the FDA.
2:06.0	So where you're likely to see this potentially is in ASCVD, so high-risk patients where we need to lower cholesterol,
2:16.0	and patients may not tolerate higher dose statins.
2:21.2	They may not want to do an injection like the PCSK9 inhibitors or they might not be at goal
2:29.0	quite yet. So many of these patients were going to target probably an LDL goal of less than 70 for high-risk
2:36.6	cardiovascular patients, so patients who've had a heart attack, stroke in the past.
2:42.9	With that, if they don't meet that goal with statin therapy and other, you know, is etymide,
2:49.8	usually.
	...

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