Bempedoic acid (Nexletol)
Bempedoic acid (Nexletol) is a once-daily non-statin tablet. In CLEAR Harmony, 180 mg daily lowered LDL cholesterol by 16.5% from the on-treatment baseline at 12 weeks, an 18.1-percentage-point advantage over placebo. Study results
How much does bempedoic acid lower LDL cholesterol?
Bempedoic acid 180 mg daily lowered LDL cholesterol by 16.5% from baseline at 12 weeks in CLEAR Harmony, compared with a 1.6% increase with placebo, on background lipid-lowering therapy. Read the evidence.
| Dose and treatment context | LDL result |
|---|---|
| 180 mg daily, background therapy continued | 18.1 percentage points vs. placebo |
This is additional lowering on existing treatment. Results in people taking little or no statin may differ from this trial.
Individual responses vary. LDL and ApoB measure different things; these LDL percentages should not be used as ApoB estimates. Compare ApoB-lowering treatments.
How is bempedoic acid taken?
Nexletol is taken as one 180 mg tablet daily, with or without food. It blocks ATP citrate lyase, an enzyme involved in cholesterol production upstream of the enzyme targeted by statins. Prescribing information.
How does bempedoic acid compare with other medications?
Bempedoic acid lowers LDL less than typical PCSK9 regimens but is an oral option with outcome evidence in statin-intolerant patients. Nexlizet combines it with Ezetimibe for a larger LDL reduction.
Which medications can be combined with bempedoic acid?
Bempedoic acid can be added to a tolerated statin or ezetimibe. Avoid combining it with simvastatin doses above 20 mg or pravastatin doses above 40 mg because it can increase statin exposure. Do not combine Nexletol with Nexlizet, which already contains bempedoic acid.
How much does bempedoic acid cost?
Eligible commercially insured patients may pay as little as $10 for a 30-day prescription or $25 for 90 days. This is copay assistance, not an uninsured cash price. Offers checked October 6, 2026; availability and eligibility can change.
NEXSTEP copay program
Eligible commercially insured patients may pay as little as $10 for a 30-day prescription or $25 for 90 days. This is copay assistance, not an uninsured cash price.
GoodRx
Compare available pharmacy cash prices and coupons for the exact product and quantity. A pharmacy price may exclude administration charges and may differ from a manufacturer program.
Compare the cash price with your plan’s out-of-pocket quote for the same strength and quantity. Coupon purchases may not count toward your insurance deductible.
Does insurance cover bempedoic acid?
Coverage for bempedoic acid varies by plan and formulation. These named formularies and medical policies were checked October 6, 2026; your plan’s rules and cost sharing may differ.
| Insurer | Coverage policy |
|---|---|
| UnitedHealthcare | Nexletol is Tier 2 with prior authorization, step therapy, and a quantity limit. Commercial PDL, September 2026. |
| Aetna | Nexletol is preferred brand; no additional requirement is shown in this formulary row. Advanced Control, October 2026. |
| Cigna | Cigna lists Nexletol at Tier 2 with prior authorization and a one-tablet daily limit. California Standard 4-Tier (DMHC), July 2026. |
| Anthem | No listing for bempedoic acid was located in this named pharmacy formulary. This does not establish a denial; ask the plan about its current drug list, exceptions, and medical-benefit coverage. California Individual Select, October 2026. |
| Blue Shield of California | No listing for bempedoic acid was located in this named pharmacy formulary. This does not establish a denial; ask the plan about its current drug list, exceptions, and medical-benefit coverage. Standard Formulary. |
| BCBS of Texas | Nexletol is preferred brand with prior authorization and a 30-tablet-per-30-day limit. Performance Annual, 2026. |
What are the side effects of bempedoic acid?
Bempedoic acid can raise uric acid and cause gout. Tendon injury or rupture is another important risk; new tendon pain or swelling warrants prompt assessment. Muscle spasms, abdominal symptoms, and liver-enzyme elevations can also occur. Full safety information.
Does bempedoic acid reduce heart attacks or strokes?
In CLEAR Outcomes, the primary cardiovascular composite occurred in 11.7% of patients taking bempedoic acid and 13.3% taking placebo over a median 40.6 months. Participants were unable or unwilling to take guideline-recommended statin doses because of adverse effects. Read the supporting evidence.
Is bempedoic acid right for you?
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