Drug & supplement interaction

Guggul + Bempedoic Acid

Bempedoic Acid brand name: Nexletol.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Guggul and Bempedoic Acid in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Guggul and Bempedoic Acid

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Bempedoic Acid and Guggul in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Guggul safety at a glance

Guggul overall Use caution May cause digestive upset and skin reactions; use under guidance of a healthcare provider.
Pregnancy Likely Unsafe When used orally; avoid using. Guggul gum resin appears to stimulate menstrual flow and the uterus. Read the full pregnancy detail
Breastfeeding Avoid Not enough safety information, so it is best avoided while breastfeeding.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Bempedoic Acid and Guggul? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Bempedoic Acid

Interactions in our licensed database are recorded against drug classes, not just single drug names. Bempedoic Acid is filed under 2 classifications — organic anion transporter 3 (oat3) substrates, oral drugs. Guggul has documented interactions with 9 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), contraceptive drugs (moderate) and cytochrome p450 3a4 (cyp3a4) substrates (moderate) — and none of Bempedoic Acid’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Guggul Does Interact With Other Medications

Guggul has 757 moderate known drug interactions in our database — Bempedoic Acid isn’t one of them. If you take anything else, check it against the full list below.

Moderate 757 No known interaction 2,073 (incl. Bempedoic Acid)
Taking anything else?

Check Another of Your Medications Against Guggul

Covers the 2,830 medications we’ve checked against Guggul. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Guggul and Bempedoic Acid May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • An allergic reaction Worth acting on Additional detail

    Guggul

    “Orally, guggul can cause hypersensitivity reactions including rash and pruritus. Guggul can also cause nonallergic adverse skin reactions. The risk of skin reactions appears to be dose-dependent. In one study, the incidence of skin reactions was 3% with a dosage of 1000 mg three times daily, compared with 15% with a dosage of 2000 mg three times daily.”

    Guggul · Natural Medicines adverse-effect record, reported in dermatitis.

    6 sources cited
    1. 10371. Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for treatment of hypercholesterolemia: a randomized controlled trial. JAMA 2003;290:765-72.
    2. 54457. Gelfand, J. M., Crawford, G. H., Brod, B. A., and Szazpary, P. O. Adverse cutaneous reactions to guggulipid. J.Am.Acad.Dermatol. 2005;52(3 Pt 1):533-534. PubMed
    3. 13662. Gelfand JM, Crawford GH, Brod BA, Szazpary PO. Adverse cutaneous reactions to guggulipid. J Am Acad Dermatol 2005;52:533-4 PubMed
    4. 54464. Kolonte, A., Guillot, B., and Raison-Peyron, N. Allergic contact dermatitis to guggul extract contained in an anticellulite gel-cream. Contact Dermatitis 2006;54(4):226-227. PubMed
    5. 54467. Salavert, M., Amarger, S., Le Bouedec, M. C., Roger, H., Souteyrand, P., and D'incan, M. Allergic contact dermatitis to guggul in a slimming cream. Contact Dermatitis 2007;56(5):286-287. PubMed
    6. 105751. Mehdi Z, Fatemeh P, Roja R, et al. Efficacy and safety of Hemoheal cream in patients with hemorrhoids: a randomized double-blind placebo controlled clinical trial. J Tradit Chin Med 2021;41(2):301-307.

    “Orally, guggul can cause hypersensitivity reactions including rash and pruritus. In a small clinical study, two adults with hyperlipidemia developed a hypersensitivity rash, one with facial edema, within minutes of oral administration of a methanolic extract of guggul, together with Terminalia extract.”

    Guggul · Natural Medicines adverse-effect record, reported in dermatitis.

    5 sources cited
    1. 10371. Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for treatment of hypercholesterolemia: a randomized controlled trial. JAMA 2003;290:765-72.
    2. 54457. Gelfand, J. M., Crawford, G. H., Brod, B. A., and Szazpary, P. O. Adverse cutaneous reactions to guggulipid. J.Am.Acad.Dermatol. 2005;52(3 Pt 1):533-534. PubMed
    3. 105741. Donato F, Raffetti E, Toninelli G, Festa A, Scarcella C, Castellano M; TRIGU Project Working Group. Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial. Complement Med Res 2021;28(3):216-22 PubMed
    4. 54464. Kolonte, A., Guillot, B., and Raison-Peyron, N. Allergic contact dermatitis to guggul extract contained in an anticellulite gel-cream. Contact Dermatitis 2006;54(4):226-227. PubMed
    5. 54467. Salavert, M., Amarger, S., Le Bouedec, M. C., Roger, H., Souteyrand, P., and D'incan, M. Allergic contact dermatitis to guggul in a slimming cream. Contact Dermatitis 2007;56(5):286-287. PubMed

    Bempedoic Acid

    Listed in the ADVERSE REACTIONS section of the FDA label for Bempedoic Acid. Read the label on DailyMed ›

  • Diarrhea Additional detail

    Guggul

    “Orally, guggul can cause nausea, vomiting, loose stools, diarrhea, belching, bloating, hiccups, and mild gastrointestinal discomfort.”

    Guggul · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 3267. Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994;8:659-64. PubMed
    2. 8155. Agarwal RC, Singh SP, Saran RK, et al. Clinical trial of gugulipid – a new hypolipidemic agent of plant origin in primary hyperlipidemia. Ind J Med Res 1986;84:626-34.
    3. 8158. Malhotra SC, Ahuja MM, Sundaram KR. Long term clinical studies on the hypolipidaemic effect of Commiphora mukul (Guggulu) and clofibrate. Indian J Med Res 1977;65:390-5.
    4. 10371. Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for treatment of hypercholesterolemia: a randomized controlled trial. JAMA 2003;290:765-72.
    5. 52033. Nohr, L. A., Rasmussen, L. B., and Straand, J. Resin from the mukul myrrh tree, guggul, can it be used for treating hypercholesterolemia? A randomized, controlled study. Complement Ther.Med. 2009;17(1):16-22. PubMed
    6. 54492. Malhotra SC, Ahuja MM. Comparative hypolipidaemic effectiveness of gum guggulu (Commiphora mukul) fraction 'A', ethyl-P-chlorophenoxyisobutyrate and Ciba-13437-Su. Indian J Med Res 1971;59:1621-1632.

    Bempedoic Acid

    Listed in the ADVERSE REACTIONS section of the FDA label for Bempedoic Acid. Read the label on DailyMed ›

  • A skin rash Additional detail

    Guggul

    Recorded for Guggul in the same Natural Medicines adverse-effect record shown under Diarrhea above.

    Bempedoic Acid

    Listed in the ADVERSE REACTIONS section of the FDA label for Bempedoic Acid. Read the label on DailyMed ›

Reported for Guggul but not commonly for Bempedoic Acid: stomach upset, severe muscle breakdown, headache and vomiting.

Effects for Bempedoic Acid come from the ADVERSE REACTIONS section of its FDA label; effects for Guggul come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 3,204 voluntary FDA FAERS reports for Bempedoic Acid that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Guggul in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally; avoid using. Guggul gum resin appears to stimulate menstrual flow and the uterus.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Bempedoic Acid Is Prescribed For, and What Guggul Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Bempedoic Acid is a prescription medicine with approved uses on its FDA label. Guggul is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Bempedoic Acid is prescribed for: Nexletol (bempedoic acid) is used in adults to reduce the risk of major cardiovascular events — including cardiovascular death, heart attack, stroke, and procedures to open blocked arteries — in people at increased cardiovascular risk who are unable to take recommended statin therapy. Nexletol is also used alongside diet and exercise to lower LDL cholesterol in adults with high cholesterol (hypercholesterolemia), including a genetic form called heterozygous familial hypercholesterolemia (HeFH). It can be used with other cholesterol-lowering medicines or alone when combining with another therapy isn't possible.

Guggul has been studied for:

  • Hypercholesterolemia studied, not established Guggul has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Guggul for hypercholesterolemia

    Several small, low-quality clinical studies in Indian populations suggest that oral guggul may reduce cholesterol levels in patients with hypercholesterolemia; however, more recent evidence in patients on Western diets contradicts these findings.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Bempedoic Acid on your own; if you are taking Guggul for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Guggul or Bempedoic Acid

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Guggul or Bempedoic Acid, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Bempedoic Acid

This page covers Guggul only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bempedoic Acid page lists 21 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), African Wild Potato (moderate), Banderol (moderate), Caffeic Acid (moderate) and Coffee Charcoal (moderate).

By severity: 1 major · 11 moderate · 9 minor.

From our pharmacist’s overview on the Bempedoic Acid page

“Activated charcoal is the ingredient I would rule out entirely on bempedoic acid (Nexletol), a daily tablet for lowering LDL cholesterol. It carries the only major rating of the 21 ingredients on file because it can trap the drug in the gut and shrink the dose your body absorbs.”

Reviewed by 2 · Jul 18, 2026

Open the Bempedoic Acid interaction page

One more smart check

Taking Guggul as Part of a Dietary Supplement Product? Check It for Interactions

We hold 955 real supplement products containing Guggul, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Guggul. Even though Guggul itself has no known interaction with Bempedoic Acid, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Guggul and Bempedoic Acid Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Guggul
Top 25%

#184 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Bempedoic Acid
Top half

#749 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Guggul reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Guggul and Bempedoic Acid records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Guggul

What is Guggul?

Guggul
  • High cholesterol
  • Joint pain and arthritis
  • Weight management
  • Acne
  • Skin conditions

Guggul is a gum resin from the Commiphora wightii tree, long used in Ayurvedic medicine for cholesterol, joint, and skin problems. Modern studies are mixed and often low-quality, and it can cause stomach upset and skin rashes. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Commiphora wightii · Burseraceae · Gum resin (oleoresin) from the stem · Capsules, tablets, standardized extracts (guggulipid), powders

An interaction check asks whether these two react with each other — it does not ask whether Guggul is a good idea for someone in your situation. Here is what our Guggul record says about it on its own.

Guggul: dosing

There is no single established, proven dose for guggul. Products vary widely in strength, and many are standardized to a percentage of guggulsterones. Do not assume that taking more will work better, since higher amounts may increase the chance of side effects.

From our Guggul monograph — the full record covers uses, side effects and every documented interaction.

Read the full Guggul monograph & all interactions
Medication

About Bempedoic Acid

What Is Bempedoic Acid Used For?

Brand name: Nexletol

Nexletol (bempedoic acid) is used in adults to reduce the risk of major cardiovascular events — including cardiovascular death, heart attack, stroke, and procedures to open blocked arteries — in people at increased cardiovascular risk who are unable to take recommended statin therapy.

Nexletol is also used alongside diet and exercise to lower LDL cholesterol in adults with high cholesterol (hypercholesterolemia), including a genetic form called heterozygous familial hypercholesterolemia (HeFH). It can be used with other cholesterol-lowering medicines or alone when combining with another therapy isn't possible.

Most-Reported Side Effects for Bempedoic Acid

From FAERS, the FDA’s public side-effect reporting system (3,204 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Myalgia 454 reports
Arthralgia 301 reports
Pain in extremity 203 reports
Muscle spasms 202 reports
Nausea 172 reports
See full Bempedoic Acid drug information
Keep checking

Other Drugs & Guggul

Browse every other medication we’ve checked against Guggul — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
757Moderate
0Minor
2,072No known interaction
757 Moderate 2,072 No interaction
Moderate

757 interactions

Showing 60 of 757 moderate interactions — see all 757 on the Guggul page.

No interaction 2,072 drugs checked — show the list

We also checked Guggul against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,072 medications checked with no known interaction — see the full Guggul list.

See the full Guggul interactions page
See every supplement checked against Bempedoic Acid, ranked by severity
Evidence & sources

Guggul References

The 21 references that drive our Guggul monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Dalvi SS, Nayak VK, Pohujani SM, et al. Effect of gugulipid on bioavailability of diltiazem and propranolol. J Assoc Phys India 1994;42:454-5.
  3. Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994;8:659-64. PubMed
  4. Tripathi YB, Tripathi P, Malhotra OP, Tripathi SN. Thyroid stimulatory action of (Z)-guggulsterone: mechanism of action. Planta Med 1988;54:271-7.
  5. Agarwal RC, Singh SP, Saran RK, et al. Clinical trial of gugulipid – a new hypolipidemic agent of plant origin in primary hyperlipidemia. Ind J Med Res 1986;84:626-34.
  6. Malhotra SC, Ahuja MM, Sundaram KR. Long term clinical studies on the hypolipidaemic effect of Commiphora mukul (Guggulu) and clofibrate. Indian J Med Res 1977;65:390-5.
  7. Mester L, Mester M, Nityanand S. Inhibition of platelet aggregation by "guggulu" steroids. Planta Med 1979;37:367-9. PubMed
  8. Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for treatment of hypercholesterolemia: a randomized controlled trial. JAMA 2003;290:765-72.
  9. Brobst DE, Ding X, Creech KL, et al. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 2004;310:528-35. PubMed
  10. Bianchi A, Cantu P, Firenzuoli F, et al. Rhabdomyolysis caused by Commiphora mukul, a natural lipid-lowering agent. Ann Pharmacother 2004;38:1222-5.
  11. Gelfand JM, Crawford GH, Brod BA, Szazpary PO. Adverse cutaneous reactions to guggulipid. J Am Acad Dermatol 2005;52:533-4 PubMed
  12. Nohr, L. A., Rasmussen, L. B., and Straand, J. Resin from the mukul myrrh tree, guggul, can it be used for treating hypercholesterolemia? A randomized, controlled study. Complement Ther.Med. 2009;17(1):16-22. PubMed
  13. Gelfand, J. M., Crawford, G. H., Brod, B. A., and Szazpary, P. O. Adverse cutaneous reactions to guggulipid. J.Am.Acad.Dermatol. 2005;52(3 Pt 1):533-534. PubMed
  14. Kolonte, A., Guillot, B., and Raison-Peyron, N. Allergic contact dermatitis to guggul extract contained in an anticellulite gel-cream. Contact Dermatitis 2006;54(4):226-227. PubMed
  15. Salavert, M., Amarger, S., Le Bouedec, M. C., Roger, H., Souteyrand, P., and D'incan, M. Allergic contact dermatitis to guggul in a slimming cream. Contact Dermatitis 2007;56(5):286-287. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Guggul and Bempedoic Acid Together: Common Questions

Is it safe to take Guggul with Bempedoic Acid?
We do not list a known interaction between Guggul and Bempedoic Acid. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Guggul and Bempedoic Acid have any of the same side effects?
Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Guggul and Bempedoic Acid used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Guggul in each. That is a conversation for your prescriber, especially if Bempedoic Acid is being adjusted to a target.
How was the Guggul and Bempedoic Acid combination checked?
Interactions in our licensed database are recorded against drug classes. Bempedoic Acid is filed under 2 classifications, and Guggul has documented interactions with 9 drug classes — none of Bempedoic Acid's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Guggul interact with any other medications?
Yes. Guggul has 757 documented drug interactions in our database — Bempedoic Acid is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Bempedoic Acid interact with any supplements?
Yes. Bempedoic Acid has documented interactions with 21 supplements in our database — Guggul is not one of them. The Bempedoic Acid interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Guggul monograph Uses, safety profile, and every drug interaction in one place Bempedoic Acid drug information The full plain-English guide to this medication Bempedoic Acid supplement interactions Every supplement checked against Bempedoic Acid, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 21 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Bempedoic Acid and Guggul?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.