ATP-citrate lyase inhibitor + cholesterol absorption inhibitor
Bempedoic acid with ezetimibe
Brand names: Nustendi
Adult dose
Dose: 1 tablet (180/10mg) OD
Route: Oral
Frequency: OD
Clinical pearls
- NICE TA729: primary hypercholesterolaemia where statin not tolerated / insufficient
- ESC/EAS
- CLEAR Outcomes evidence base
Contraindications
- Pregnancy
- Severe hepatic impairment
- Hypersensitivity
Side effects
- Hyperuricaemia
- Tendinopathy
- GI upset
- LFT changes
- Atrial fibrillation
Interactions
- Ciclosporin
- Statins (simvastatin >20mg)
- UGT2B7 substrates
Monitoring
- LFTs
- Uric acid
- Lipid profile
- Tendon symptoms
Reference: BNF; NICE TA729; ESC/EAS; SmPC; https://bnf.nice.org.uk/drugs/bempedoic-acid-with-ezetimibe/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Framingham Risk Score · Cardiovascular Risk
- Reynolds Risk Score for Women · Cardiovascular Risk
- SCORE2 — 10-Year CVD Risk (Age 40–69) · Cardiovascular Risk
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- UK Prospective Diabetes Study (UKPDS) Risk Engine · Prognosis
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