Bempedoic Acid and Simvastatin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Bempedoic Acid
Simvastatin
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased simvastatin exposure and an increased risk of myopathy
Interaction Deep Dive
Concomitant use of bempedoic acid and simvastatin causes an increase in simvastatin concentration and may increase the risk of simvastatin-related myopathy. Administration of simvastatin 20 mg with bempedoic acid 240 mg or simvastatin 40 mg with bempedoic acid 180 mg in healthy subjects at steady-state resulted in approximately 2-fold increases in simvastatin acid AUC and 1.5-fold increases in simvastatin acid Cmax. Avoid concomitant use of bempedoic acid with simvastatin doses greater than 20 mg1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) Administration of simvastatin 20 mg with bempedoic acid 240 mg or simvastatin 40 mg with bempedoic acid 180 mg in healthy subjects at steady-state resulted in approximately 2-fold increases in simvastatin acid AUC (91% for 20 mg and 96% for 40 mg) and 1.5-fold increases in simvastatin acid Cmax (54% for 20 mg and 52% for 40 mg) 1.
Common questions
Can I take Bempedoic Acid and Simvastatin together?
Increased simvastatin exposure and an increased risk of myopathy Always confirm with your pharmacist or prescriber before making any change.
How serious is the Bempedoic Acid and Simvastatin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Bempedoic Acid or Simvastatin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: NEXLETOL(R) oral tablets, bempedoic acid oral tablets. Esperion Therapeutics Inc (per FDA), Ann Arbor, MI, 2024. DailyMed
Keep reading about Bempedoic Acid
Keep reading about Simvastatin
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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