Bempedoic Acid and Ezetimibe side effects: what 686 FDA adverse event reports show
Drug class
Adenosine Triphosphate-Citrate Lyase Inhibitor
Label matched
Bempedoic Acid (Nexletol)
Who reports
686 reports · 21% serious · 5 with death outcome · 63% female
Used for
NEXLETOL is indicated: to reduce the risk of major adverse cardiovascular events (cardiovascular death, myocardial infarction, stroke, or coronary revascularization) in adults at increased risk for these events who are unable to take recommended statin therapy (including those not taking a statin).
What it is
NEXLETOL tablets, for oral use, contain bempedoic acid, an adenosine triphosphate-citrate lyase (ACL) inhibitor.
Boxed warning
None in the current label
Causality screen of the 4 strongest signals
What the badges mean
- Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 2 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Tendon rupture (torn tendon) | 17 | 42.0 26.2–67.1ROR 43.0 · χ² 639 / p 3e-141 | 40.2 EB05 26.6 · IC025 +3.5 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 29.1 | no trial data cached |
| Gout | 17 | 28.9 18.1–46.2ROR 29.6 · χ² 430 / p 6e-96 | 28.1 EB05 18.5 · IC025 +3.2 3/3 methods agree | Labeled adverse reaction exact term | – | no trial data cached |
| Blood triglycerides increased | 15 | 25.8 15.7–42.6ROR 26.4 · χ² 334 / p 7e-75 | 25.1 EB05 16.0 · IC025 +3.0 3/3 methods agree | Labeled (related wording) related wording | serious PRR 21.9 | no trial data cached |
| Tendonitis | 12 | 23.6 13.4–41.3ROR 24.0 · χ² 237 / p 8e-54 | 22.6 EB05 13.5 · IC025 +2.7 3/3 methods agree | Labeled (related wording) related wording | serious PRR 20.2 | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Gout | 17 | 28.9 18.1–46.2ROR 29.6 · χ² 430 / p 6e-96 | 28.1 EB05 18.5 · IC025 +3.2 3/3 methods agree | Labeled adverse reaction exact term | – | no trial data cached |
| Tendon rupture (torn tendon) | 17 | 42.0 26.2–67.1ROR 43.0 · χ² 639 / p 3e-141 | 40.2 EB05 26.6 · IC025 +3.5 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 29.1 | no trial data cached |
| Blood triglycerides increased | 15 | 25.8 15.7–42.6ROR 26.4 · χ² 334 / p 7e-75 | 25.1 EB05 16.0 · IC025 +3.0 3/3 methods agree | Labeled (related wording) related wording | serious PRR 21.9 | no trial data cached |
| Tendonitis | 12 | 23.6 13.4–41.3ROR 24.0 · χ² 237 / p 8e-54 | 22.6 EB05 13.5 · IC025 +2.7 3/3 methods agree | Labeled (related wording) related wording | serious PRR 20.2 | no trial data cached |
| Product dispensing error | 4 | 5.6 2.1–14.9ROR 5.6 · χ² 11 / p 5e-4 | 3.7 EB05 1.6 · IC025 +0.1 | Reporting / coding artifact | – | no trial data cached |
| Device difficult to use | 3 | 1.4 0.4–4.3ROR 1.4 · χ² 0 / p 0.410 | 1.4 EB05 0.6 · IC025 -1.7 PRR-only: not supported by EBGM or IC | Reporting / coding artifact | serious PRR 20.1 | no trial data cached |
Unlabeled candidate signals
Every screened signal with n ≥ 20 was either labeled, an indication term, or an artifact pattern — no unlabeled candidate stood out in the top signals.
✓ A hand-written Bradford Hill causality assessment exists for this drug: Zoledronic acid (bisphosphonates) ↔ Osteonecrosis of the jaw.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Bempedoic Acid and Ezetimibe?
In FDA FAERS, the most frequently co-reported reaction terms for Bempedoic Acid and Ezetimibe are gout, tendon rupture, blood triglycerides increased, tendonitis. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Bempedoic Acid and Ezetimibe have an FDA boxed warning?
No. The FDA label retrieved for Bempedoic Acid and Ezetimibe has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Bempedoic Acid and Ezetimibe causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 88d06d89-a3da-40b4-b273-8f4f7d56c4c9, effective 20260625; matched on
openfda.generic_name.exact:"BEMPEDOIC ACID") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 6 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.