| Hypercholesterolemia
Nextletol vs Nexlizet
Side-by-side clinical, coverage, and cost comparison for hypercholesterolemia.Deep comparison between: Nexletol vs Nexlizet 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 signalsNexlizet has a higher rate of injection site reactions vs Nexletol based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Nexlizet but not Nexletol, including UnitedHealthcare
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Category
Nexletol
Nexlizet
At A Glance
Oral
Daily
ACL inhibitor
Oral
Daily
ACL inhibitor / cholesterol absorption inhibitor
Indications
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Hypercholesterolemia
- Atherosclerosis
Dosing
Hypercholesterolemia, Familial hypercholesterolemia - heterozygous 180 mg orally once daily with or without food; analyze lipid levels within 8 to 12 weeks after initiation.
Hypercholesterolemia, Atherosclerosis One tablet (180 mg bempedoic acid and 10 mg ezetimibe) orally once daily, with or without food.
Coadministration with bile acid sequestrants Administer at least 2 hours before or at least 4 hours after bile acid sequestrants.
Contraindications
- Prior serious hypersensitivity reaction to bempedoic acid or any excipient in NEXLETOL
- Prior hypersensitivity to ezetimibe or bempedoic acid or any of the excipients in NEXLIZET
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%) Upper respiratory tract infection, muscle spasms, hyperuricemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anemia, elevated liver enzymes, diarrhea, arthralgia, sinusitis, fatigue, influenza
Serious Hyperuricemia, tendon rupture
Postmarketing Thrombocytopenia, abdominal pain, pancreatitis, nausea, hepatitis, cholelithiasis, cholecystitis, anaphylaxis, angioedema, myopathy/rhabdomyolysis, dizziness, paresthesia, depression, headache, erythema multiforme
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.
NEXLIZET combines bempedoic acid, an ACL inhibitor that lowers LDL-C by blocking hepatic cholesterol synthesis upstream of HMG-CoA reductase via inhibition of ATP-citrate lyase, with ezetimibe, which reduces LDL-C by inhibiting intestinal cholesterol absorption via the NPC1L1 sterol transporter, together acting through complementary mechanisms to decrease circulating LDL-C.
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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)
Nexlizet
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (11/12) · Qty limit (11/12)
UnitedHealthcare
Nexletol
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Nexlizet
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Humana
Nexletol
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Nexlizet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Nexletol.
No savings programs available for Nexlizet.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.