Recommended Daily Dose of Bempedoic Acid
The recommended daily dose of bempedoic acid is 180 mg taken orally once daily, with or without food. 1, 2, 3
Standard Dosing Protocol
Take 180 mg orally once daily as a single dose, which can be administered with or without food. 1, 2, 3
The tablet must be swallowed whole and should not be crushed or split. 2
No dose adjustment is required based on LDL-C response—the dose remains fixed at 180 mg daily regardless of lipid levels achieved. 2
Combination Therapy Dosing
When using the fixed-dose combination product with ezetimibe, take one tablet containing 180 mg bempedoic acid plus 10 mg ezetimibe once daily. 1, 2
If combining with bile acid sequestrants, administer bempedoic acid either 2 hours before or 4 hours after the bile acid sequestrant to avoid binding interactions. 2
Critical Dosing Restrictions with Statins
Do not exceed simvastatin 20 mg daily when used concomitantly with bempedoic acid due to increased statin exposure risk. 1, 2
Do not exceed pravastatin 40 mg daily when used concomitantly with bempedoic acid due to increased statin exposure risk. 1, 2
No dose restrictions apply when combining bempedoic acid with other statins (atorvastatin, rosuvastatin, etc.). 1
Special Population Considerations
No dosage adjustment is necessary in patients with mild or moderate hepatic impairment (Child-Pugh A or B). 3
Patients with severe hepatic impairment (Child-Pugh C) have not been studied, so use caution in this population. 3
No renal dose adjustment is required, though bempedoic acid exposure increases 1.5-fold in mild renal impairment, 2.3-fold in moderate impairment, and 2-fold in severe impairment. 3
Mandatory Safety Monitoring
Assess serum uric acid levels before initiating therapy and monitor if symptoms of hyperuricemia develop, as bempedoic acid increases uric acid by a mean of 0.8 mg/dL. 1, 2, 4
Monitor for signs and symptoms of tendinitis or tendon rupture; discontinue immediately if tendon rupture occurs. 1, 2
Monitor liver function tests as clinically indicated, particularly at baseline and periodically during treatment. 5, 2
Common Pitfalls to Avoid
Do not attempt to titrate the dose based on LDL-C response—180 mg daily is the only approved dose. 2
Do not combine with high-dose simvastatin (>20 mg) or pravastatin (>40 mg) as this significantly increases statin exposure and toxicity risk. 1, 2
Do not discontinue monitoring for hyperuricemia, as gout occurs in 1.5% of patients on bempedoic acid versus 0.4% on placebo. 6, 7