What is Nexletol and How Does It Work?
Nexletol, with the generic name bempedoic acid, is a prescription medication designed to lower low-density lipoprotein (LDL) cholesterol, often referred to as 'bad' cholesterol [1.7.5]. It is used in conjunction with diet and sometimes other cholesterol-lowering medicines for adults with primary hyperlipidemia, including the inherited condition heterozygous familial hypercholesterolemia (HeFH) [1.7.3]. Nexletol is also approved to reduce the risk of heart attack and coronary procedures (like stent placement or bypass surgery) in adults who have known heart disease or are at high risk for it, especially those who cannot take recommended statin treatments [1.7.2, 1.7.6].
Nexletol works differently from statins. It is an adenosine triphosphate-citrate lyase (ACL) inhibitor [1.7.3]. It blocks the ACL enzyme in the liver, which is a key step in the body's cholesterol production process [1.7.7]. By inhibiting this enzyme, Nexletol reduces the amount of cholesterol the liver produces [1.7.1]. A key feature of bempedoic acid is that it is a prodrug, meaning it is inactive when taken and becomes activated primarily in the liver. This targeted activation is thought to reduce the risk of muscle-related side effects that are sometimes associated with statins [1.7.4]. The standard dosage is a 180 mg tablet taken once daily, with or without food [1.7.6].
Can Nexletol Cause Diarrhea? Examining the Evidence
Yes, diarrhea is a recognized side effect of Nexletol (bempedoic acid) [1.2.3, 1.3.4]. Clinical trial data provides specific insights into its frequency. In primary hyperlipidemia trials, adverse reactions led to patients stopping their medication. While muscle spasms were the most common reason, diarrhea was the second most frequent, leading to discontinuation in 0.4% of Nexletol-treated patients compared to just 0.1% of patients taking a placebo [1.2.1, 1.4.3].
Nexletol is also available in a combination pill called Nexlizet, which pairs bempedoic acid with ezetimibe. For Nexlizet, diarrhea is also listed among the more common side effects, alongside issues like muscle spasms, back pain, and abdominal pain [1.2.4]. In studies specifically looking at ezetimibe, diarrhea was reported in 13.2% of users [1.4.6]. While diarrhea is a noted side effect for Nexletol on its own, its incidence appears to be higher when bempedoic acid is combined with ezetimibe [1.2.2]. The side effect is generally considered mild and temporary for many patients [1.2.4].
Managing Gastrointestinal Side Effects of Nexletol
If you experience diarrhea while taking Nexletol, several management strategies can help. First, it's important to stay hydrated, as diarrhea can lead to fluid loss [1.5.4]. Over-the-counter (OTC) antidiarrheal medications may be recommended by your healthcare team to help relieve symptoms [1.5.4].
Dietary adjustments can also play a crucial role. It may be helpful to avoid foods known to worsen diarrhea, such as spicy or greasy foods [1.5.1]. Eating smaller, more frequent meals can also be easier on your digestive system. If you experience stomach pain along with diarrhea, taking Nexletol with food might provide some relief [1.5.1].
It is essential to keep your doctor informed. While many side effects are mild and may resolve on their own, you should contact your doctor if the diarrhea is severe, persistent, or accompanied by other concerning symptoms like severe vomiting or right-sided stomach pain, which could indicate a rarer side effect like gallstones [1.5.1, 1.5.4]. Your doctor can evaluate the situation to determine if the symptom is a side effect of the medication or due to another cause [1.5.4].
Comparison of Common Side Effects: Nexletol vs. Statins
Nexletol is often prescribed for individuals who are intolerant to statins, particularly due to muscle-related side effects [1.6.2]. While both classes of drugs lower cholesterol, their side effect profiles have key differences.
| Side Effect Profile | Nexletol (Bempedoic Acid) | Statins (e.g., Atorvastatin) |
|---|---|---|
| Primary Mechanism | ACL inhibitor, activated in the liver [1.7.4]. | HMG-CoA reductase inhibitors [1.7.4]. |
| Muscle-Related Pain | Less likely to cause muscle pain than statins [1.6.1, 1.7.4]. Muscle spasms are a common side effect [1.2.1]. | Muscle pain is a well-known side effect, affecting up to 19% of users in some studies [1.6.6]. |
| Gastrointestinal | Can cause diarrhea, abdominal pain, and constipation [1.2.4, 1.3.7, 1.2.6]. | Can cause abdominal pain, but diarrhea is also a possible side effect [1.6.3]. |
| Uric Acid | Known to increase uric acid levels (hyperuricemia), which can lead to gout [1.6.4, 1.5.6]. | Generally do not have a significant impact on uric acid levels [1.6.4]. |
| Blood Sugar | Does not appear to raise blood glucose or the risk of diabetes [1.7.4]. | Some statins can cause raised blood sugar levels [1.6.3]. |
| Other Common Effects | Upper respiratory tract infections, back pain, anemia, and elevated liver enzymes [1.7.7]. | Headaches, weakness, and dizziness have been reported [1.6.6]. |
Conclusion
In conclusion, Nexletol (bempedoic acid) can indeed cause diarrhea. It is documented as a common, though usually mild, gastrointestinal side effect in clinical trials and is one of the reported reasons for patients discontinuing the medication [1.2.1, 1.2.3]. While Nexletol offers a valuable alternative for cholesterol management, particularly for those intolerant to statins due to its lower risk of muscle pain, patients should be aware of its potential side effects [1.6.2]. Managing diarrhea typically involves staying hydrated and making dietary adjustments, but it is crucial to consult a healthcare provider for persistent or severe symptoms to ensure proper care and to rule out other issues [1.5.4]. Always discuss your full medical history with your doctor before starting any new medication.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
For more detailed information from the manufacturer, you can visit The official Nexletol website.
