Gout from Bempedoic Acid: Causes, Risks, and What to Do

When you take bempedoic acid, a cholesterol-lowering drug used when statins aren’t enough or cause side effects. Also known as Nexletol, it helps lower LDL by blocking an enzyme in the liver that makes cholesterol. But for some people, it does something unexpected—it raises uric acid levels, which can lead to gout, a painful form of arthritis caused by uric acid crystals building up in joints. This isn’t rare. Studies show about 3% to 5% of people on bempedoic acid develop gout within the first year, especially if they already have high uric acid or a history of gout.

Why does this happen? Bempedoic acid works in the liver, but it also affects how the body clears uric acid through the kidneys. Less clearance means more uric acid in the blood—hyperuricemia, the medical term for too much uric acid in the bloodstream. That’s the first step toward gout. It’s not the drug’s main job, but it’s a real side effect you can’t ignore. If you’re on bempedoic acid and suddenly get a swollen, red, burning big toe or ankle, don’t assume it’s just an injury. It could be gout triggered by your medication.

What can you do? First, talk to your doctor before stopping anything. You might need a simple blood test to check your uric acid levels. If they’re high, your doctor might add a low-dose colchicine to prevent flares, or switch you to another cholesterol drug like ezetimibe. Drinking more water, cutting back on alcohol and red meat, and avoiding sugary drinks can also help. Gout from bempedoic acid doesn’t mean you have to give up your heart protection—it just means you need a smarter plan.

The posts below cover real-world strategies for managing side effects like this. You’ll find guides on how to track medication changes, what to ask your pharmacy when switching drugs, and how to spot hidden risks in common treatments. Whether you’re dealing with gout, high cholesterol, or drug interactions, these resources give you the facts without the fluff.