Names and pronunciation
(bem′pe-doe′ik as′id) Nexletol
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Drug reference
(bem′pe-doe′ik as′id) Nexletol
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Func. class.: Antilipemic
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Chem. class.: Adenosine triphosphate– citrate lyase inhibitor
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ACTION: Lowers low-density lipoprotein choles- terol (LDL-C) by inhibiting cholesterol synthesis in the liver
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USES: Atherosclerotic CV disease, heterozygous familial hypercholesterolemia, as an adjunct to diet and statin therapy
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CONTRAINDICATIONS Hypersensitivity Precautions: Severe renal/hepatic dis- ease, myopathy, tendon rupture, chil- dren, hyperuricemia
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SIDE EFFECTS ENDO: Hyperuricemia CV: Atrial fibrillation GI: Abdominal distress GU: BPH HEMA: Anemia, leukopenia MS: Back/limb pain, muscle spasm, gout RESP: URI
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INTERACTIONS Increase: effect of—OATP1B1/1B3 (SLCO1B1/1B3) inhibitors, avoid combination Increase: myopathy risk—pravastatin, sim- vastatin, avoid pravastatin doses of >40 mg/ day, simvastatin doses >30 mg/day Drug/Lab Test: Increase: LFTs, BUN, serum creatinine, CK NURSING CONSIDERATIONS
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DOSAGE AND ROUTES • Adult: PO 180 mg daily
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Available forms: Tabs 180 mg
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Administer: • Give without regard to food • Store in original package (with desic- cant) at room temperature
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Assess: • Monitor lipid panel 3-4 mo after start- ing treatment • Myopathy/tendon rupture: Assess for muscle tenderness, spasms, weakness; monitor doses of statins; notify provider immediately of tendon rupture, discon- tinue product • Hyperuricemia: Monitor uric acid levels if needed and assess for signs/ symptoms of gout, if indicated use urate- lowering products • Pregnancy/breastfeeding: Do not use in pregnancy, avoid breastfeeding
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Evaluate: • Therapeutic response: Decrease in LDL-C levels
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Patient and caregiver information: • Hyperuricemia: Teach patients about the risk of elevated serum uric acid levels, with possibility of gout, that lab exams will be needed, to contact pre- scriber if signs/symptoms of gout develop • Tendon rupture risk: Advise patients of tendon rupture, to rest at the first sign of tendinitis or tendon rupture, immedi- ately contact provider • Myopathy risk (simvastatin or prav B astatin): Teach patients to notify provid- ers if they are taking simvastatin or pravastatin, myopathy risk is increased with use of these products • Pregnancy/breastfeeding: Teach pa- tient to notify prescriber if pregnancy is planned or suspected or if breastfeeding
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PHARMACOKINETICS Onset/duration unknown, peak 3.5 hr, half-life 21 hr
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• Adult: PO 180 mg daily
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