Nexlizet

Introduction

Written by Sarah Lewis, PharmD
Medically reviewed by Melissa Badowski, PharmD, MPH, FCCP 
Updated on October 12, 2023

Nexlizet (NEX-lee-zet) is a brand-name medication prescribed for atherosclerosis (hardening of the arteries) and a certain kind of high cholesterol called heterozygous familial hypercholesterolemia. Nexlizet belongs to a group of drugs called cholesterol-lowering medications.

Side effects of Nexlizet

Nexlizet may cause mild or serious side effects. More common mild side effects of Nexlizet and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about Nexlizet’s side effects, see this article or ask your doctor or pharmacist. You can also refer to the prescribing information for Nexlizet listed in the “Resources” section.

Mild side effects

More common mild side effects reported with Nexlizet are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about Nexlizet’s side effects, refer to the prescribing information for Nexlizet listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Nexlizet’s mild side effects include:

• belly pain or discomfort
• constipation
• fatigue (low energy)
• muscle spasms
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for Nexlizet” section.

Serious side effects

Serious side effects of Nexlizet are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about Nexlizet’s side effects, refer to the prescribing information for Nexlizet listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, Nexlizet’s serious side effects include: 

• atrial fibrillation (an abnormal heart rhythm)
• changes in blood cell count levels
• enlarged prostate gland
• high uric acid levels, which can lead to gout (a form of arthritis)
• liver problems
• joint pain
• torn tendons
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for Nexlizet” section.

Common questions about Nexlizet

Below you’ll find answers to a few commonly asked questions about Nexlizet.

Can Nexlizet cause weight gain or weight loss?

No, changes in weight aren’t an expected side effect of Nexlizet. In studies, weight gain and weight loss weren’t reported.

But doctors prescribe Nexlizet in combination with a low fat diet. Eating this kind of diet can cause weight loss.

If you’re experiencing a change in your weight, tell your doctor. They can determine the most likely cause and suggest ways to manage it, if necessary.

How does Nexlizet work? And how long does it take to start working?

Nexlizet contains two drugs, bempedoic acid and ezetimibe. Bempedoic acid works by stopping your liver from making cholesterol. Ezetimibe works by stopping your intestines from absorbing cholesterol from food that you eat. Together, this helps lower the level of cholesterol in your blood.

Nexlizet will start working to lower cholesterol levels right after you take it. But it can take a few weeks to see its full effects. Your doctor will order a lab test to check your cholesterol levels about 8–12 weeks after you start Nexlizet.

If you’d like to know more about this, talk with your doctor or pharmacist.

Uses of Nexlizet

The Food and Drug Administration (FDA) approves prescription drugs such as Nexlizet for certain conditions. Approved uses for Nexlizet are described below. These uses differ based on the form of Nexlizet prescribed.

Use for lowering LDL cholesterol

Doctors may prescribe Nexlizet oral tablet for treating atherosclerosis (hardening of the arteries) and a certain kind of high cholesterol called heterozygous familial hypercholesterolemia (HeFH). It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

With atherosclerosis, plaque builds up inside your arteries. Plaque is a waxy substance that contains cholesterol and other fats. Over time, plaque hardens and narrows your arteries. This makes it hard for blood to flow. Atherosclerosis doesn’t always cause symptoms. You may not know you have it until something serious happens, such as a heart attack.

HeFH is a rare form of high cholesterol that is inherited from a parent. People with HeFH can have symptoms, including fatty deposits around joints, on tendons, or around or in the eye.

Nexlizet is prescribed together with a low fat diet and statin medications.

Interactions and warnings for Nexlizet

Below you’ll find information about Nexlizet’s possible interactions and warnings.

Interactions of Nexlizet

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take Nexlizet, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs 
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for Nexlizet” section below.

Warnings for Nexlizet

Some people should not take Nexlizet, and others should take it cautiously.

Nexlizet could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether Nexlizet is a safe option for you.

Ask your doctor about specific warnings for Nexlizet, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Nexlizet can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to Nexlizet or any of its ingredients, your doctor will likely not prescribe Nexlizet. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to Nexlizet, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of Nexlizet

You should not take more Nexlizet than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much Nexlizet, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and Nexlizet

Information about Nexlizet and pregnancy and breastfeeding is described below.

Nexlizet and pregnancy

Nexlizet should not be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor may suggest birth control options to use during treatment with Nexlizet.

Nexlizet and breastfeeding

Nexlizet should not be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with Nexlizet.

What to ask your doctor

Let your doctor know if you have questions about Nexlizet or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How should I take Nexlizet?
• Do any of my other medications interact with Nexlizet?
• Am I at higher risk of side effects than other people?
• What is the most important information I need to know about Nexlizet?

Resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Nexlizet (bempedoic acid and ezetimibe) tablets, for oral use. (2023). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/211617s018lbl.pdf

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.