Bempedoic acid is indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease (ASCVD) who require additional reduction of LDL cholesterol (LDL-C).

Bempedoic acid is an adenosine triphosphate-citrate lyase (ACL) inhibitor that reduces low-density lipoprotein cholesterol (LDL-C) by inhibiting cholesterol synthesis in the liver. ACL is an enzyme that acts upstream of HMG-CoA reductase in the cholesterol biosynthesis pathway. Bempedoic acid is converted into its active form by the enzyme very long-chain acyl-CoA synthetase 1 (ACSVL1), which is primarily expressed in the liver. Its active metabolite inhibits ACL, resulting in decreased cholesterol production in the liver and increased expression of LDL receptors, thereby enhancing the clearance of LDL-C from the bloodstream.

Administer 180 mg orally once daily with or without food.

Simvastatin: Avoid concomitant use with simvastatin doses greater than 20 mg.
Pravastatin: Avoid concomitant use with pravastatin doses greater than 40 mg.

• Upper respiratory tract infection
• Muscle spasms
• Hyperuricemia
• Back pain
• Abdominal pain or discomfort
• Bronchitis
• Pain in extremities
• Anemia
• Elevated liver enzymes

Discontinue Bempedoic acid if pregnancy is detected unless the potential benefit justifies the potential risk. There are no adequate data regarding its use in pregnant women. It is not known whether bempedoic acid is excreted in human or animal milk. Due to the potential for adverse effects, breastfeeding is not recommended during treatment.

Increases in serum uric acid levels have been observed; therefore, monitor uric acid periodically and manage hyperuricemia as needed. Cases of tendon rupture have been reported. Discontinue the drug at the first sign of tendon injury. Avoid use in patients with a history of tendon disorders or rupture.

Store below 30°C, protected from light and moisture. Keep out of reach of children.