What Is Nexlizet? Uses, Dosage, and What You Need to Know in 2026

Nexlizet is a prescription cholesterol-lowering medication that has emerged as an important option for adults who cannot take statins or need additional LDL reduction beyond what a statin provides. If you've been prescribed Nexlizet — or you're wondering whether it might be right for you — this guide covers everything you need to know about how it works, how to take it, and what to expect.

What Is Nexlizet?

Nexlizet is a brand-name oral tablet containing two active ingredients: bempedoic acid (180 mg) and ezetimibe (10 mg). It is manufactured by Esperion Therapeutics and was first approved by the FDA on February 26, 2020, making it the first non-statin, fixed-dose combination cholesterol-lowering pill ever approved in the United States.

Nexlizet belongs to the drug class "antihyperlipidemic combinations." It is NOT a statin and does not contain a statin. This distinction is important for patients who have experienced statin intolerance (typically muscle pain or weakness) and need an alternative approach to managing high cholesterol.

What Is Nexlizet Used For?

The FDA has approved Nexlizet for two main indications:

Lowering LDL ("bad") cholesterol: Nexlizet is indicated as an adjunct to diet, alone or in combination with other cholesterol-lowering drugs, to reduce LDL-C in adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH). It can be used with or without a statin.

Reducing cardiovascular risk: The bempedoic acid component of Nexlizet is approved to reduce the risk of heart attack and coronary revascularization (procedures like stent placement or bypass surgery) in adults with established cardiovascular disease or at high cardiovascular risk, who are unable to take recommended statin therapy.

In clinical trials, Nexlizet reduced LDL cholesterol by approximately 36-38% compared to placebo — a meaningful reduction that can help patients achieve guideline-recommended LDL targets. In the landmark CLEAR Outcomes trial (N=13,970), bempedoic acid also reduced the risk of heart attacks by 23% and the need for coronary procedures by 19% in statin-intolerant patients.

How Do You Take Nexlizet?

Nexlizet is taken as follows:

Dose: One tablet (180 mg bempedoic acid / 10 mg ezetimibe) once daily

With or without food: Nexlizet can be taken any time of day, with or without a meal

Swallow whole: Do not cut, crush, or chew the tablets

Consistency: Take at the same time each day for consistent blood levels

Missed dose: Take as soon as you remember; do not double the next dose

Lab monitoring: Your doctor will check your lipid levels within 8-12 weeks of starting treatment

Who Should NOT Take Nexlizet?

Nexlizet is contraindicated (should not be used) in:

Patients with known hypersensitivity to bempedoic acid or ezetimibe

Pregnant women — Nexlizet may harm an unborn baby. If you become pregnant while on Nexlizet, contact your doctor immediately and report to Esperion at 1-833-377-7633.

Breastfeeding mothers — it is not known if Nexlizet passes into breast milk; breastfeeding is not recommended during treatment

Pediatric patients — safety and effectiveness have not been established in children

How Long Does It Take for Nexlizet to Work?

Most patients begin to see LDL reduction within 4 weeks of starting Nexlizet. Your doctor will typically order a lipid panel (blood test) 8-12 weeks after you start treatment to assess the medication's effectiveness and determine if any dose or therapy adjustments are needed. Nexlizet is a long-term medication — patients take it indefinitely as part of ongoing cholesterol management.

Is There a Generic for Nexlizet?

No. As of 2026, there is no FDA-approved generic version of Nexlizet. The retail price is $430-$595 per month, but the Esperion Copay Card can reduce cost to $10/fill for eligible commercially insured patients. GoodRx pricing is available at approximately $231/month.

See our complete guide on how to save money on Nexlizet in 2026 for all available savings options.

If you're having trouble finding Nexlizet at a pharmacy near you, medfinder can locate which pharmacies in your area have it in stock.