Meta Information
ID:bempedoic-acid
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/intervention/simvastatin
Target name:
Simvastatin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Bempedoic acid inhibits transporters (OATP1B1/1B3) needed to clear simvastatin, increasing its concentration by about 2-fold and raising the risk of muscle-related side effects (myopathy).
Actionable advice:
Do not exceed a daily dose of 20 mg of simvastatin when taking bempedoic acid.
Target id:
/intervention/pravastatin
Target name:
Pravastatin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Bempedoic acid inhibits transporters (OATP1B1/1B3) needed to clear pravastatin, increasing its concentration by about 1.9-fold and raising the risk of muscle-related side effects (myopathy).
Actionable advice:
Do not exceed a daily dose of 40 mg of pravastatin when taking bempedoic acid.
Target id:
/class/statins
Target name:
Statins (e.g., Atorvastatin, Rosuvastatin)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Bempedoic acid can increase the blood levels of most statins by inhibiting their uptake into the liver, which may increase the risk of muscle pain and weakness.
Actionable advice:
Use the lowest necessary statin dose and monitor for any new or worsening muscle symptoms.
Target id:
/intervention/ezetimibe
Target name:
Ezetimibe
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Description:
Bempedoic acid (reduces cholesterol production) and ezetimibe (reduces cholesterol absorption) work via complementary pathways to provide a greater LDL cholesterol-lowering effect when used together.
Actionable advice:
This combination is often used intentionally for enhanced cholesterol management; they can be taken at the same time.
Target id:
/biomarker/uric-acid
Target name:
Uric Acid
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Bempedoic acid can slightly inhibit the kidney's ability to excrete uric acid by blocking the OAT2 transporter, leading to a small increase in blood uric acid levels.
Actionable advice:
Be aware that a small, clinically insignificant rise in uric acid may occur during treatment.
Target id:
/condition/gout
Target name:
Gout or Hyperuricemia
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
By increasing blood uric acid levels, bempedoic acid may increase the risk of gout attacks in individuals with a history of the condition or high baseline uric acid.
Actionable advice:
If you have a history of gout, monitor for symptoms and discuss uric acid levels with your doctor.
Target id:
/condition/geriatric
Target name:
Age Over 60
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
An increased risk of tendon rupture has been observed with bempedoic acid, and this risk is higher in patients over 60 years of age.
Actionable advice:
If you are over 60, be vigilant for any new tendon pain or swelling and report it promptly.
Target id:
/class/corticosteroids
Target name:
Corticosteroids (e.g., Prednisone)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Concurrent use of corticosteroids, which can weaken connective tissue, may further increase the risk of tendon rupture associated with bempedoic acid.
Actionable advice:
Avoid concurrent use if possible; otherwise, be extra cautious about tendon pain or injury.
Target id:
/class/fluoroquinolones
Target name:
Fluoroquinolone Antibiotics
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Concurrent use of fluoroquinolone antibiotics, which carry their own risk of tendon injury, may further increase the risk of tendon rupture associated with bempedoic acid.
Actionable advice:
Avoid concurrent use if possible; otherwise, be extra cautious about tendon pain or injury.
Target id:
/condition/renal-impairment
Target name:
Severe Renal Impairment (eGFR < 30)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Severe kidney disease can increase blood levels of bempedoic acid and also independently increases the risk of tendon rupture, compounding the risk.
Actionable advice:
Use with caution and under close medical supervision if you have severe kidney disease.
Target id:
/condition/end-stage-renal-disease
Target name:
End-Stage Renal Disease (on Dialysis)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
The use of bempedoic acid has not been studied in patients with end-stage renal disease receiving dialysis, so its safety is unknown.
Actionable advice:
Avoid using bempedoic acid if you are on dialysis.
Target id:
/condition/hepatic-impairment
Target name:
Severe Hepatic Impairment (Child-Pugh C)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Bempedoic acid is activated in the liver and has not been studied in patients with severe liver disease; its use is not recommended.
Actionable advice:
Do not use if you have severe liver disease.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Bempedoic acid lowers cholesterol, which is essential for normal fetal development. Its use may cause fetal harm and is contraindicated during pregnancy.
Actionable advice:
Avoid completely if you are pregnant or planning to become pregnant.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
It is unknown if bempedoic acid passes into breast milk, but due to the potential for serious adverse reactions in a breastfed infant, it is not recommended.
Actionable advice:
Avoid completely while breastfeeding.
Target id:
/class/immunosuppressants
Target name:
Cyclosporine
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Cyclosporine strongly inhibits transporters (OATP1B1/1B3) responsible for bempedoic acid uptake, which can significantly increase its concentration and risk of side effects.
Actionable advice:
Concurrent use with cyclosporine should be avoided.
Target id:
/intervention/probenecid
Target name:
Probenecid
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Probenecid can inhibit the metabolism (glucuronidation) of bempedoic acid's active form, potentially increasing its levels and the risk of adverse effects.
Actionable advice:
Monitor for side effects if co-administration is necessary.
Target id:
/class/fibrates
Target name:
Fibrates
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Although clinical trials with fenofibrate did not show increased muscle-related side effects, fibrates as a class can cause myopathy, warranting caution when combined with bempedoic acid.
Actionable advice:
Use with caution and monitor for any new or worsening muscle symptoms.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Description:
The absorption and effectiveness of bempedoic acid are not significantly affected by food, offering flexibility in administration.
Actionable advice:
Take at the same time each day, with or without food, for consistency.