Bempedoic Acid Side Effects: What You Need to Know Before Taking It

When your body can’t handle statins but your cholesterol is still too high, bempedoic acid, a non-statin cholesterol-lowering drug that works in the liver to reduce LDL. Also known as Nexletol, it’s designed for people who can’t tolerate statins due to muscle pain or other side effects. Unlike statins, bempedoic acid doesn’t enter the bloodstream in large amounts, which is why it’s often chosen when statins fail. But that doesn’t mean it’s side effect-free. You need to know what to watch for—especially if you’re already managing other conditions like diabetes or kidney disease.

Bempedoic acid is often used alongside other cholesterol drugs like ezetimibe or PCSK9 inhibitors. It’s not a magic bullet. Studies show it lowers LDL by about 20%, which is solid but not as strong as high-dose statins. The biggest concern? Increased risk of tendon rupture, especially in people over 60 or those taking corticosteroids. It can also raise uric acid levels, which might trigger gout in susceptible individuals. Some users report mild side effects like stomach pain, fatigue, or elevated liver enzymes. If you’ve had kidney issues or are on multiple medications, your doctor should check your labs regularly. This isn’t a drug you start and forget about—it requires monitoring.

People who struggle with statin intolerance often turn to bempedoic acid because it’s taken once daily and doesn’t cause the muscle pain that sends so many patients off statins. But if you’ve had tendon problems before, or if you’re active in sports or manual labor, you should talk to your doctor about alternatives. It’s also not recommended for people with severe liver disease. The good news? It’s been approved for use in the U.S. and Europe, and real-world data is growing. Many patients find it works well when paired with diet changes and exercise. But it’s not a substitute for lifestyle changes—it’s a tool to help when those alone aren’t enough.

If you’re considering bempedoic acid, don’t just accept it because your statins didn’t work. Ask your doctor about your specific risk factors, what side effects are most likely for you, and how often you’ll need blood tests. Compare it to other options like ezetimibe or PCSK9 inhibitors—some might be more effective or safer depending on your history. This isn’t about finding the strongest drug. It’s about finding the right one for your body.

Below, you’ll find real-world insights from patients and doctors on how bempedoic acid fits into broader medication plans, what to expect when switching from statins, and how to manage its side effects without giving up on your heart health.