ATP-citrate lyase inhibitor (lipid-lowering)
Bempedoic acid
Brand names: Nilemdo
Adult dose
Dose: 180mg PO OD
Route: Oral
Frequency: OD
Clinical pearls
- NICE TA694: primary hypercholesterolaemia / mixed dyslipidaemia when statin not tolerated or insufficient
- ESC/EAS dyslipidaemia guidelines
- CLEAR Outcomes (2023): CV risk reduction in statin-intolerant patients
Contraindications
- Pregnancy
- Breastfeeding
- Hypersensitivity
Side effects
- Hyperuricaemia / gout
- Tendinopathy / tendon rupture
- Anaemia
- Abdominal pain
- Hepatic enzyme elevation
- Atrial fibrillation
Interactions
- Statins (simvastatin >20mg, pravastatin >40mg — avoid)
- UGT2B7 substrates
Monitoring
- LFTs
- Uric acid
- Tendon symptoms
- Lipid profile
Reference: BNF; NICE TA694; ESC/EAS; SmPC; https://bnf.nice.org.uk/drugs/bempedoic-acid/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- LDL Cholesterol — Friedewald Equation · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- Tumor Lysis Syndrome Risk (Cairo-Bishop) · Oncological Emergency
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines