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Bempedoic acid oral

Updated 2 Feb 2023 | Other lipid-regulating drugs


Oral formulations of bempedoic acid.

Drugs List

  • bempedoic acid 180mg tablets
  • NILEMDO 180mg film coated tablets
  • Therapeutic Indications


    Mixed dyslipidaemia: adjunct to diet and exercise
    Primary hypercholesterolaemia: lipid lowering therapy adjunct to diet

    Treatment of primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia, as an adjunct to diet:
    in combination with statin or statin with other lipid-lowering therapies in patients unable to reach LDL-C goals with the maximum tolerated dose of a statin or,
    alone or in combination with other lipid-lowering therapies in patients for who statin is contraindicated or who are statin-intolerant.



    180mg once daily.

    Additional Dosage Information

    Concomitant doses of simvastatin should be limited to 20mg daily. A dose of 40mg daily may be used in patients with severe hypercholesterolaemia and high risk cardiovascular complications, who have not achieved their treatment goals on the lower doses and when the benefits are expected to outweigh the potential risks.


    Children under 18 years

    Precautions and Warnings

    Females of childbearing potential
    End stage renal disease
    Glucose-galactose malabsorption syndrome
    History of gout
    Lactose intolerance
    Renal impairment - eGFR below 30ml/minute/1.73m sq
    Severe hepatic impairment

    Contains lactose
    Perform liver function tests before commencing therapy
    Discontinue treatment immediately if pregnancy is suspected
    Monitor hepatic function in patients with severe hepatic impairment
    Monitor patients with severe renal impairment for adverse effects
    Advise patients to report muscle pain/tenderness/weakness
    May cause hyperuricaemia
    May precipitate gout
    Discontinue if ALT or AST persistently exceed 3 x ULN
    Discontinue if CPK rises to > or equal to 10 x upper limit of normal
    Discontinue if hyperuricaemia with gout symptoms occur
    Female: Ensure adequate contraception during treatment

    If symptoms of myopathy occur whilst receiving bempedoic acid treatment and a statin, a lower maximum dose of the same statin or alternative statin, or discontinuation of bempedoic acid and initiation of an alternative lipid-lowering therapy should be considered under close monitoring.

    Pregnancy and Lactation


    Bempedoic acid is contraindicated during pregnancy.

    Use of bempedoic acid during pregnancy is contraindicated by the manufacturer. Animal studies have shown reproductive toxicity. Human data is limited and as such a potential risk cannot be ruled out. Bempedoic acid should be discontinued prior to conception.


    Bempedoic acid is contraindicated during breastfeeding.

    Use of bempedoic acid when breastfeeding is contraindicated by the manufacturer. The presence of bempedoic acid in human breast milk and the effects on exposed infants are unknown.

    Side Effects

    Alanine aminotransferase increased
    Altered liver function tests
    Aspartate aminotransferase increased
    Blood urea increased
    Creatine kinase increased
    Decrease in glomerular filtration rate
    Haemoglobin decrease
    Increase in serum ALT/AST
    Muscle spasm
    Painful extremities


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: October 2020

    Reference Sources

    Summary of Product Characteristics: Nilemdo 180mg tablets. Daiichi Sankyo UK Limited. Revised April 2020.

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