Basic Information
ID DDInter1513 and DDInter176
Interaction Concomitant administration of bempedoic acid may potentiate the risk of tendon rupture or injury associated with fluoroquinolones and corticosteroids. The mechanism is unknown. Tendon rupture or injury have most frequently involved the rotator cuff (the shoulder), biceps tendon, or Achilles tendon. Tendon rupture may occur within weeks to months of starting treatment with bempedoic acid.
Management Caution is recommended if bempedoic acid is prescribed in combination with corticosteroids or fluoroquinolones, particularly in patients with other concomitant risk factors (e.g., age over 60 years, renal failure, previous tendon disorders). Treatment with bempedoic acid should be stopped immediately if rupture of a tendon occurs. Discontinuation of treatment with bempedoic acid should be considered if the patient experiences joint pain, swelling, or inflammation. At the first sign of tendinitis or tendon rupture, the patient should be instructed to rest, avoid exercise, avoid using the affected area, and to contact their healthcare provider. An alternative therapy should be considered in patients with a history of tendon disorders or tendon rupture.
References [1] "Product Information. Nexletol (bempedoic acid)." Esperion Therapeutics, Ann Arbor, MI. [2] "Product Information. Nexlizet (bempedoic acid-ezetimibe)." Esperion Therapeutics, Ann Arbor, MI.
Alternative for Prednisolone D07A
Mometasone furoate Fluorometholone Fluocinolone acetonide Beclomethasone dipropionate Clobetasol Amcinonide
Hydrocortisone butyrate Fluocinonide Fluticasone

S01C
Fluorometholone Indomethacin
More
Alternative for Bempedoic acid C10A
Cerivastatin Probucol Fenofibric acid Mipomersen Pitavastatin Lomitapide
Dextrothyroxine Evinacumab Evolocumab Gemfibrozil Clofibrate Alirocumab

C10B
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.