Drug breakdown: Bempedoic Acid

02 September 2023
Volume 5 · Issue 9


In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #bempedoic acid

Dr Sharon Rees @reesprescribe

Day 1: A non-statin LDL-lowering agent, #bempedoic acid is a 1st in class drug, approved in 2020 & now UK recommended as a statin alternative (combined with ezetimibe). Ezetimibe is tried added to statin, or used alone 1st, before introducing #bempedoic acid. #bempedoic acid is estimated to deliver LDL-C reduction of ~ 30% alone & the statin equivalent average reduction of ~45% when combined with ezetimibe

Dr Sharon Rees @reesprescribe

Day 2: Adult oral dose 180mg od, #bempedoic acid is used for primary hypercholesterolaemia (not 1st line), as added to other agents, OR as monotherapy combined with ezetimibe. No dose adjustment is needed for the elderly

Dr Sharon Rees @reesprescribe

Day 3: #bempedoic acid is a prodrug which is activated in the liver. There is high protein binding for the parent drug & metabolites. Main breakdown is conversion via UGT2B7 into inactive glucuronide (no known phase 1 activity). Mainly renal excretion, t½ 15-24hrs

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