Nexlizet Side Effects— a combination of bempedoic acid and ezetimibe — is a prescription medication designed to lower LDL cholesterol and reduce the risk of heart attacks and certain heart-related procedures such as coronary revascularization. For many patients, it’s an important tool in managing cardiovascular disease, particularly when lifestyle changes and other medications alone aren’t enough.
But like any medication, Nexlizet comes with potential side effects. While many people tolerate it well, others may experience reactions ranging from mild discomfort to more significant health issues. Understanding these possible effects is essential for anyone taking or considering Nexlizet, because being prepared helps you make informed decisions and respond quickly if problems arise.
This in-depth guide will cover:
- The most common side effects patients report.
- Which serious but less common risks to watch out for.
- Practical tips for minimizing and managing symptoms.
- When to seek urgent medical attention.
- Alternative treatment options if Nexlizet isn’t the right fit for you.
Whether you’re just starting your prescription, have been on it for months, or are researching before speaking with your doctor, this information will help you navigate your treatment more confidently.
Understanding How Nexlizet Works and Why Side Effects Happen
Before diving into the side effects, it’s helpful to understand how Nexlizet works. The medication combines two cholesterol-lowering agents:
- Bempedoic acid – Reduces cholesterol production in the liver by inhibiting a key enzyme in the cholesterol synthesis pathway.
- Ezetimibe – Limits cholesterol absorption from the intestines.
This two-pronged approach can significantly reduce LDL (“bad”) cholesterol levels, which in turn helps lower cardiovascular risk.
However, because these drugs affect both your liver metabolism and digestion, as well as your body’s muscle and joint systems indirectly, some patients may experience unwanted changes in how their body feels or functions. Side effects can stem from the medication’s direct action on cholesterol metabolism, immune responses, or changes in gut microbiome caused by altered fat absorption.
Common Side Effects of Nexlizet
Clinical trials and patient reports show several side effects occur more frequently than others. In most cases, these reactions appear within the first few weeks of treatment and may improve as your body adapts. The most commonly reported side effects include:
- Muscle-related symptoms – muscle spasms, back pain, and joint discomfort.
- Gastrointestinal issues – diarrhea, abdominal pain, constipation in some cases.
- Respiratory infections – cold-like symptoms, sore throat, runny nose.
These effects are not dangerous for most people, but they can affect daily comfort and quality of life if left unmanaged.
Muscle Spasms and Pain
Muscle spasms — involuntary contractions or twitching — are among the most reported Nexlizet side effects. They may occur in isolated areas like the calves or in multiple muscle groups. Unlike the more serious muscle breakdown seen with some statins, Nexlizet-related spasms tend to be mild to moderate and often improve over time.
Back pain is also common, possibly due to changes in muscle tension or posture caused by mild inflammation in soft tissues. In some patients, the discomfort is temporary stiffness; in others, it’s a dull ache that can interfere with sleep or physical activity.
Joint pain can develop too, often affecting larger joints like knees, hips, or shoulders. It’s not fully understood why this occurs, but inflammation from metabolic changes or mild immune system activation may play a role.
Tips for relief:
- Stretch gently every morning and evening to reduce muscle tightness.
- Use heat therapy (warm compresses, heating pads, or baths) to relax muscles.
- Stay hydrated to help muscle tissue function optimally.
- Avoid sudden increases in physical activity when starting treatment.
Gastrointestinal Symptoms
Because one of Nexlizet’s components (ezetimibe) affects fat absorption, it’s not surprising that some patients notice changes in digestion.
Diarrhea is the most common digestive complaint, ranging from mild loose stools to multiple urgent trips to the bathroom. This often occurs in the first two weeks and may stabilize once your body adapts.
Abdominal pain — whether cramping, bloating, or a general feeling of discomfort — can also appear. Some patients experience it more after meals, especially if those meals are high in fat.
Interestingly, a smaller number of patients experience constipation instead of diarrhea. This variation is likely due to differences in diet, hydration, and gut microbiome composition.
Tips for relief:
- Eat smaller, more frequent meals rather than large, heavy portions.
- Include fiber-rich foods (vegetables, fruits, oats) to regulate bowel movements.
- Limit greasy or spicy foods if they trigger discomfort.
- If diarrhea persists, consider probiotics to restore gut balance.
Respiratory Infections
Some patients on Nexlizet experience upper respiratory tract infections more often than usual. These infections are usually mild and resemble the common cold — with symptoms like runny nose, sore throat, cough, and fatigue.
It’s unclear exactly why this happens, but mild immune system changes or increased susceptibility to seasonal viruses could be factors. While these infections usually pass within a week, they can be inconvenient and uncomfortable.
Tips for prevention:
- Wash your hands frequently and avoid touching your face.
- Get enough sleep to keep your immune system strong.
- Stay physically active — even gentle exercise supports immune health.
- Maintain a diet rich in vitamins C and D, plus zinc.
That’s the first 1,200+ words covering the title, introduction, medication background, and the first main side effect categories in expanded detail.
Less Common but More Serious Side Effects of Nexlizet
While most Nexlizet side effects are mild, a few can be more serious and require medical attention. These reactions are less frequent but are important to recognize early.
Hyperuricemia (High Uric Acid Levels)
One of the notable potential side effects of Nexlizet is elevated uric acid levels in the blood. This can occur because bempedoic acid may influence purine metabolism — a natural process in the body that produces uric acid as a byproduct.
In most cases, high uric acid levels do not cause immediate symptoms. However, if left unmanaged, they can lead to gout, a painful inflammatory arthritis that often affects the big toe but can occur in other joints.
Signs of a gout attack include:
- Sudden, intense joint pain (often at night)
- Redness and swelling around the joint
- Warmth or tenderness to touch
- Difficulty moving the affected joint
Who’s at higher risk?
- People with a history of gout
- Patients with kidney disease
- Those on dehydrating medications (like diuretics)
What to do:
- Your doctor may monitor your uric acid levels through blood tests, especially during the first month.
- If you have gout symptoms, seek medical advice promptly — early treatment can shorten the episode.
- Staying hydrated and reducing purine-rich foods (red meat, organ meats, shellfish) may help prevent flare-ups.
Tendon Rupture and Tendonitis
Rarely, Nexlizet can cause inflammation in tendons or even tendon rupture. This is more common in the Achilles tendon but can occur in the shoulders, hands, or other areas.
Warning signs include:
- Sudden pain or swelling in a tendon area
- Difficulty moving the affected limb
- A popping or snapping sound during activity
Prevention tips:
- Avoid sudden, intense exercise when starting Nexlizet.
- Warm up before physical activity and stretch afterward.
- If tendon pain appears, stop the activity immediately and see a doctor.
Allergic Reactions
Although rare, serious allergic reactions can occur with Nexlizet. These reactions can be dangerous and require emergency care.
Signs to watch for:
- Swelling of the face, lips, tongue, or throat
- Difficulty breathing or swallowing
- Severe rash or hives
- Dizziness or fainting
If any of these symptoms appear, call 911 or seek urgent medical care immediately.
Managing Side Effects at Home
Many Nexlizet side effects can be managed with simple lifestyle adjustments and self-care strategies. Here are some practical tips for common categories of symptoms:
For Muscle and Joint Discomfort
- Gentle stretching in the morning and evening can maintain flexibility.
- Use warm compresses or Epsom salt baths to relax muscles.
- Light low-impact exercise (walking, swimming, yoga) can improve circulation and reduce stiffness.
- Avoid sudden increases in physical activity until you know how your body responds.
For Digestive Issues
- Eat smaller, more frequent meals to avoid overloading the digestive system.
- Include fiber-rich foods for constipation or a bland diet (bananas, rice, applesauce, toast) for diarrhea.
- Drink plenty of water to prevent dehydration and help digestion.
- Avoid excessive alcohol and greasy foods if they worsen symptoms.
For Respiratory Infections
- Rest and avoid strenuous activity during recovery.
- Stay hydrated with water, herbal teas, or broth.
- Use a humidifier to keep nasal passages moist.
- Over-the-counter remedies can relieve congestion or sore throat — but always check with your doctor first to avoid drug interactions.
When to Call Your Doctor
It’s important to know the difference between mild, manageable side effects and symptoms that need medical attention.
Contact your healthcare provider promptly if you experience:
- Persistent or severe muscle pain
- Signs of gout (joint swelling, redness, extreme pain)
- Unusual tendon pain or swelling
- Severe digestive distress that doesn’t improve after several days
- Cold-like symptoms lasting more than 10 days or worsening over time
Seek emergency help immediately for:
- Allergic reactions (swelling, breathing difficulty, severe rash)
- Sudden tendon rupture symptoms (sharp pain, inability to move limb)
Alternative Cholesterol-Lowering Options
If Nexlizet’s side effects prove too challenging, your doctor may suggest other treatments. Some alternatives include:
- Statins – Widely prescribed, effective, but can cause muscle pain in some people.
- PCSK9 inhibitors – Injectable drugs that lower cholesterol significantly, often used when statins aren’t tolerated.
- Bile acid sequestrants – Work in the gut to lower cholesterol but may cause bloating or constipation.
- Lifestyle-only approaches – For mild cases, diet, exercise, and weight management may be enough.
Living Well While Taking Nexlizet
Nexlizet is a powerful tool in the fight against high cholesterol and cardiovascular disease, but like any medication, it can come with side effects. The key to success is balance — ensuring you get the cardiovascular protection you need while keeping unwanted symptoms under control.
Most people tolerate Nexlizet well, and for those who do experience side effects, many are temporary or manageable with the right strategies. By staying informed, tracking symptoms, and communicating openly with your healthcare provider, you can increase your chances of completing treatment successfully.
Remember, stopping cholesterol medication without medical supervision can put you at serious risk for heart attack or stroke. If side effects feel overwhelming, work with your doctor to find a solution — whether that means dose adjustments, supportive therapies, or a different cholesterol-lowering option.
Frequently Asked Questions About Nexlizet Side Effects
1. How long do Nexlizet side effects last?
Most mild side effects, like digestive discomfort or muscle aches, improve within the first few weeks as your body adjusts. Serious side effects, such as gout or tendon problems, may require medical intervention and can last longer if untreated.
2. Can Nexlizet cause fatigue?
Fatigue is not among the most common reported side effects, but some patients may feel more tired due to muscle discomfort, illness, or changes in metabolism. If fatigue is persistent, discuss it with your doctor to rule out other causes.
3. Is Nexlizet safer than statins?
Nexlizet is not necessarily “safer” than statins — it simply has a different side effect profile. Some people who cannot tolerate statins due to muscle pain may do better on Nexlizet, but both drugs can cause muscle-related symptoms.
4. Can I drink alcohol while taking Nexlizet?
Moderate alcohol use is generally safe for most people on Nexlizet, but excessive alcohol can raise uric acid levels, increasing the risk of gout. It can also strain the liver, so discuss your alcohol intake with your doctor.
5. Should I stop Nexlizet if I have side effects?
Never stop taking Nexlizet without consulting your healthcare provider. Many side effects can be managed, and stopping suddenly could increase your cardiovascular risk.
Final Thoughts
Your journey with Nexlizet should be a collaborative effort between you and your healthcare team. With the right knowledge and proactive care, you can reduce your cholesterol, protect your heart, and maintain your quality of life.
If you experience any new, unusual, or worsening symptoms, report them promptly. Early action often prevents complications and helps your medical team make the best decisions for your health.
Medical Disclaimer:
This article is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider before making any decisions about your medication or treatment plan. Never ignore medical guidance or delay seeking help because of information you read online.
