Gout from Bempedoic Acid: Causes, Risks, and What to Do
When you take bempedoic acid, a cholesterol-lowering medication approved for patients who can't tolerate statins. Also known as Nexletol, it works by blocking an enzyme in the liver that makes cholesterol. But it also affects how your body handles uric acid — and that’s where trouble can start. If you’ve been prescribed bempedoic acid and suddenly feel sharp pain in your big toe, ankle, or knee, it might not be a random flare-up. It could be gout triggered by the drug itself.
High uric acid levels, called hyperuricemia, a condition where uric acid builds up in the blood, are the root cause of gout. Bempedoic acid reduces cholesterol by interfering with the same metabolic pathway that clears uric acid. The result? Uric acid doesn’t get flushed out as well. Studies show about 1 in 10 people on bempedoic acid develop higher uric acid levels, and roughly 1 in 25 end up with a gout attack. That’s not rare — it’s a known side effect, not a glitch.
This isn’t just about pills and numbers. If you’re on bempedoic acid and have a history of gout, kidney issues, or obesity, your risk goes up. You might not even realize your joint pain is linked to your medication. Many patients assume it’s from diet, alcohol, or aging — but if you started bempedoic acid a few months ago and gout flares began around the same time, the connection is likely real.
Doctors don’t always warn patients about this. The focus is on lowering LDL cholesterol, and gout gets sidelined. But if you’re managing heart disease and now can’t walk without pain, that’s a problem that needs fixing. You don’t have to stop the drug — but you do need to act. Your doctor can check your uric acid levels, adjust your dose, or add a low-dose uric acid-lowering pill like allopurinol. Some people switch to other cholesterol meds like ezetimibe or PCSK9 inhibitors that don’t raise uric acid.
And if you’re not on bempedoic acid yet? Ask your doctor: "Will this raise my uric acid?" If you’ve had gout before, they should screen you before starting. If you’re already on it and haven’t been tested, get your levels checked. It’s a simple blood test — no needles, no pain, just a quick answer that could save you months of agony.
What you’ll find below are real, practical posts that dig into how medications like bempedoic acid affect your body in ways you might not expect — from joint pain to kidney stress, from drug interactions to safer alternatives. These aren’t theory pieces. They’re guides written for people who’ve been caught off guard by side effects and want to understand what’s really happening — and what to do next.
