Bempedoic Acid and Ezetimibe

Hypolipidaemic/Anti-atheroma · Adenosine triphosphate citrate lyase (ACL) inhibitor/Cholesterol absorption inhibitor

Indications

As an adjunct to diet, alone or in combination with other LDL-C lowering therapies, for primary hyperlipidaemia, including heterozygous familial hypercholesterolaemia (HeFH). Bempedoic acid reduces the risk of myocardial infarction and coronary revascularization in patients with established CVD, or a high risk for a CVD event (unable to take recommended statin therapy).

Dosage

Adults: 1 tab (180/10 mg) once daily.

Adverse Effects

Upper respiratory tract infection, muscle spasms, hyperuricaemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anaemia, elevated liver enzymes, diarrhoea, arthralgia, sinusitis, fatigue, influenza, renal impairment, gout, cholelithiasis, nausea, abdominal pain, thrombocytopaenia, pancreatitis, dizziness, depression, headache, erythema multiforme, myopathy/rhabdomyolysis, elevated creatine phosphokinase.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: History of tendon disorders or tendon rupture. Precautions: Assess uric acid levels periodically. Monitor for signs and symptoms of hyperuricaemia. Discontinue at the first sign of tendon rupture.

Interactions

Simvastatin, pravastatin (avoid). Cyclosporine. Fibrates (consider alternative).

Advice to Patient

Take with or without meals. Swallow whole tab. Take at least 2 hrs before or at least 4 hrs after bile acid sequestrants. Rest at the first sign of tendinitis or tendon rupture and immediately inform prescriber.

Pharmacokinetics

BEMPEDOIC ACID: Time to peak: 3.5 hrs. Metabolism: Hepatic. Excretion: Urine (70%). Faeces (30%). EZETIMIBE: Onset of action: Within 1 wk. Max effect: 2-4 wks. Metabolism: Small intestine and liver. Bioavailability: Variable. Hepatic impairment: Moderate hepatic impairment (Child-Pugh score 7-9): AUC increased 3-4 times. Severe hepatic impairment (Child-Pugh 10-15): AUC increased 5-6 times. Renal impairment: Severe renal dysfunction (CrCl <30 mL/min/1.73 m2): AUC increased 1.5 times. Half-life elimination: 22 hrs (ezetimibe and metabolite).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.