What is the onset of action of Nexlizet (bempedoic acid and ezetimibe)?

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Last updated: March 10, 2025 • View editorial policy

From the Research

Nexlizet typically begins to lower cholesterol levels within 1-2 weeks, but it reaches its full therapeutic effect after about 4 weeks of consistent use. This medication, which combines bempedoic acid and ezetimibe, works through dual mechanisms to reduce cholesterol: bempedoic acid inhibits an enzyme involved in cholesterol production in the liver, while ezetimibe decreases cholesterol absorption in the intestines 1. Patients should take Nexlizet once daily with or without food as prescribed, and continue regular use to maintain its cholesterol-lowering benefits.

Key Points to Consider

  • The efficacy and safety of bempedoic acid added to ezetimibe in statin-intolerant patients with hypercholesterolemia have been evaluated in several studies, including a randomized, placebo-controlled study 2.
  • Bempedoic acid has been shown to reduce LDL-C levels by 28.5% more than placebo when added to background lipid-modifying therapy that includes ezetimibe 2.
  • The fixed-dose combination of bempedoic acid and ezetimibe has been found to significantly reduce lipid parameters, including LDL-C, total cholesterol, and non-high-density lipoprotein cholesterol, as well as highly sensitive C-reactive protein levels 3.
  • It's essential to follow your doctor's recommendations regarding dosage and to continue any prescribed diet and exercise program while taking this medication.
  • Regular blood tests will help monitor your cholesterol levels and determine the medication's effectiveness for your specific situation.
  • Some patients may experience side effects such as muscle pain, joint pain, or elevated liver enzymes, so reporting any unusual symptoms to your healthcare provider is crucial 1, 2, 3.

Mechanism of Action

The dual mechanisms of action of Nexlizet, which combines bempedoic acid and ezetimibe, provide a comprehensive approach to reducing cholesterol levels. Bempedoic acid inhibits the adenosine triphosphate-citrate lyase enzyme in the cholesterol biosynthesis pathway, while ezetimibe decreases cholesterol absorption in the intestines 1, 4. This combination has been shown to be effective in reducing cardiovascular risk in statin-intolerant patients 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.