Bempedoic Acid: A Statin Alternative to Reduce Cholesterol
Bempedoic acid is sold under the brand name Nexletol on its own and as a combination drug with ezetimibe called Nexlizet.
Ezetimibe is a tablet that lowers cholesterol. It may be prescribed if statins cannot be taken, or alongside a statin for extra cholesterol-lowering. It's a 'cholesterol absorption inhibitor' that limits the absorption of cholesterol in the small intestine.
Fear of side effects and perceived side effects are the most common reasons for declining or discontinuing statin therapy. Willingness to take a statin is high, among both patients who have declined statin therapy and those who have never been offered one.
High cholesterol levels are considered: too high: between 5 and 6.4mmol/l. very high: between 6.5 and 7.8mmol/l. extremely high: above 7.8mmol/l.
If you've made lifestyle changes through diet and exercise that have lowered your cholesterol levels, you may not need to continue taking a statin. These changes can help reduce your risk of heart attack, stroke, or blocked arteries while allowing you to take one less medication.
By Lauran Neergaard • Published March 6, 2023
shows the cholesterol-lowering drug Nexletol made by Esperion Therapeutics Inc. Drugs known as statins are the first-choice treatment for high cholesterol but millions of people who can't or won't take those pills because of side effects may have another option.
Statins are the most common medicine for high cholesterol. They reduce the amount of cholesterol your body makes.
A newer drug called Nexletol was approved in 2020 by the FDA to treat high cholesterol, but the new study published in NEJM shows that the drug also reduces the risk of heart disease. Researchers believe this data supports using Nexletol as a safe and effective alternative for many people who cannot take statins.
The American College of Cardiology and American Heart Association developed some prescription guidelines. Typically, if a person's LDL cholesterol (bad cholesterol) is 190 or higher, they're often advised to start a statin.
The new bempedoic acid drug – currently called Nexletol – is being developed by US-based Esperion Therapeutics and will go to the Therapeutics Goods Administration for approval for use in Australia.
Joseph A. Hill, M.D., Ph. D. The controversy in the United Kingdom started in 2013 when the British Medical Journal (BMJ) claimed statins were being overprescribed to people with low risk of heart disease, and that the drugs' side effects were worse than previously thought.
Statin use is associated with increased calorie intake and consequent weight gain. It is speculated that statin‐dependent improvements in lipid profile may undermine the perceived need to follow lipid‐lowering and other dietary recommendations leading consequently to increased calorie intake.
Statins in particular can help lower your LDL cholesterol (the “bad” cholesterol) by 30% to 50%, but their effects go away after you stop taking them.
Grapefruit juice is the only food or drink that has a direct interaction with statins. Statins do not directly interact with any food but people taking statins should moderate their intake of saturated fats to help lower their LDL cholesterol and overall risk of cardiovascular disease.
After having their cholesterol tested, seniors should be given a number between 190 and 260. Healthy seniors should keep their total cholesterol below 200 and their LDL cholesterol around 100. If your elderly loved one's LDL cholesterol level is above 160, he or she must start making sweeping lifestyle changes.
A person is considered at high risk for developing heart disease if their total cholesterol level is higher than 240 mg/dL, LDL levels are higher than 160 mg/dL (190 mg/dL is even higher risk), and if the HDL level is below 40 mg/dL.
The National Institute for Health and Care Excellence (NICE) recommends that adults with a total cholesterol level of above 7.5mmol/l before treatment should be assessed for familial hypercholesterolaemia.
Because many factors are involved, your cholesterol numbers may be considered normal and yet you may still be found to be at an elevated risk for heart problems. As a result, statin medications are now used to lower the risk of heart disease and heart events in most anyone found to be at high risk.
Which cholesterol-lowering drug is the safest? Overall, statins are safe as a class of drugs. Serious adverse events are very rare. Among the individual medications, studies have shown that simvastatin (Zocor®) and pravastatin (Pravachol®) seem to be safer and better tolerated than the other statins.
Over 20 percent refused to take statin medications when first offered the medication even though they were all considered high risk. Women were 20 percent more likely than men to refuse initially: 24.1 percent versus 19.7 percent.