| Familial hypercholesterolemia - heterozygous
Nextletol vs Welchol
Side-by-side clinical, coverage, and cost comparison for familial hypercholesterolemia - heterozygous.Deep comparison between: Nexletol vs Welchol with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsWelchol has a higher rate of injection site reactions vs Nexletol based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Welchol but not Nexletol, including UnitedHealthcare
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Category
Nexletol
Welchol
At A Glance
Oral
Daily
ACL inhibitor
Oral
Daily
Bile acid sequestrant
Indications
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Familial hyperlipidemia
- Familial hypercholesterolemia - heterozygous
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Hypercholesterolemia, Familial hypercholesterolemia - heterozygous 180 mg orally once daily with or without food; analyze lipid levels within 8 to 12 weeks after initiation.
Familial hyperlipidemia, Familial hypercholesterolemia - heterozygous 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Diabetes Mellitus, Non-Insulin-Dependent 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Contraindications
- Prior serious hypersensitivity reaction to bempedoic acid or any excipient in NEXLETOL
- Serum TG concentrations >500 mg/dL
- History of hypertriglyceridemia-induced pancreatitis
- History of bowel obstruction
Adverse Reactions
Most common (>=2%) Upper respiratory tract infection, muscle spasms, hyperuricemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anemia, elevated liver enzymes
Serious Hyperuricemia, tendon rupture
Postmarketing Angioedema, wheezing, rash, urticaria
Most common (>=2%) Constipation, dyspepsia, nausea, asthenia, pharyngitis, myalgia (primary hyperlipidemia); constipation, dyspepsia, nausea, hypertension, back pain (type 2 diabetes)
Serious Hypertriglyceridemia, pancreatitis, gastrointestinal obstruction, vitamin K and fat-soluble vitamin deficiencies
Postmarketing Bowel obstruction, dysphagia, esophageal obstruction, fecal impaction, pancreatitis, hypertriglyceridemia, increased transaminases
Pharmacology
Bempedoic acid is an ACL inhibitor that lowers LDL-C by inhibiting cholesterol synthesis in the liver upstream of HMG-CoA reductase; it requires CoA activation by ACSVL1 (expressed primarily in the liver) and upregulates LDL receptors to reduce circulating LDL-C.
Colesevelam hydrochloride is a non-absorbed bile acid sequestrant that binds bile acids in the intestine, depletes the bile acid pool, upregulates hepatic cholesterol 7-alpha-hydroxylase, increases LDL receptor expression, and thereby lowers serum LDL-C; the mechanism by which it improves glycemic control in type 2 diabetes is unknown.
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Most Common Insurance
Anthem BCBS
Nexletol
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (11/12) · Qty limit (11/12)
Welchol
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Nexletol
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Welchol
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Nexletol
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Welchol
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Nexletol.
No savings programs available for Welchol.
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NexletolView full Nexletol profile
WelcholView full Welchol profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.