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bempedoic acid 🐶 Veterinary Use | Indications/Contra | FAERs-F | FAERs-M | Orange Bk | PK/Tox | Related Drugs | BioActivity |
| Stem definition | Drug id | CAS RN |
|---|---|---|
| 5382 | 738606-46-7 |
Description:
| Molecule | Description |
|---|---|
|
Synonyms:
|
Bempedoic acid is an adenosine triphosphate-citrate lyase (ACL) inhibitor that lowers low-density lipoprotein cholesterol (LDL-C) by inhibition of cholesterol synthesis in the liver. ACL is an enzyme upstream of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase in the cholesterol biosynthesis pathway. Bempedoic acid and its active metabolite, ESP15228, require coenzyme A (CoA) activation by very long-chain acyl-CoA synthetase 1 (ACSVL1) to ETC-1002-CoA and ESP15228-CoA, respectively. ACSVL1 is expressed primarily in the liver. Inhibition of ACL by ETC-1002-CoA results in decreased cholesterol synthesis in the liver and lowers LDL-C in blood via upregulation of low-density lipoprotein receptors
Legend: OFP - off patent OFM - off market ONP - on patent |
Drug dosage:
| Dose | Unit | Route |
|---|---|---|
| 0.18 | g | O |
ADMET properties:
| Property | Value | Reference |
|---|---|---|
| BDDCS (Biopharmaceutical Drug Disposition Classification System) | 2 | Bocci G, Oprea TI, Benet LZ |
Predicted pharmacokinetic/toxicological properties (PK-AZ):
| Property | Description | Value | Unit | Confidence | Similarity |
|---|---|---|---|---|---|
| kinase-safety-class | ACVR2A,ACVR2B,AURKA,AXL,BRAF,BTK,CAMK2D,CDK4,CDK5,CDK9,DDR1,DYRK1B,EGFR,EIF2AK3,EPHB4,ERBB2,GRK2,IKBKB,ITK,JAK2,JAK3,MAP2K6,MAP3K21,MAP3K7,MAPK10,MAPK7,MAPKAPK2,NTRK2,PDK1,PDK2,PDK4,PIK3CB,PIK3CG,PIM2,PRKDC,SIK2,STK33,SYK,TEK,TGFBR1,ZAP70 | 41 | |||
| kinase-selectivity-class | AXL,CDK4,EIF2AK3,EPHB4,GRK2,INSR,MAP2K6,PLK1,PLK4,PTK2,STK33,TEK | 12 | |||
| pfas-class | PFAS structural alert (1 = True, 0 = False) | 0 |
Approvals:
| Date | Agency | Company | Orphan |
|---|---|---|---|
| Feb. 21, 2020 | FDA | ESPERION THERAPS INC | |
| April 1, 2020 | EMA | FGK Representative Service GmbH |
FDA Adverse Event Reporting System (Female)
| MedDRA adverse event term | Likelihood ratio | Likelihood ratio threshold | Patients taking drug having adverse event | Patients taking drug not having adverse event | Patients not taking drug having adverse event | Patients not taking drug not having adverse event |
|---|---|---|---|---|---|---|
| Myalgia | 426.26 | 37.76 | 147 | 1498 | 174978 | 90451824 |
| Gout | 99.00 | 37.76 | 28 | 1617 | 16831 | 90609971 |
| Muscle spasms | 89.69 | 37.76 | 56 | 1589 | 251827 | 90374975 |
| Blood uric acid increased | 60.06 | 37.76 | 16 | 1629 | 7688 | 90619114 |
| Muscle rupture | 52.29 | 37.76 | 12 | 1633 | 3129 | 90623673 |
| Arthralgia | 40.08 | 37.76 | 59 | 1586 | 778463 | 89848339 |
| Blood uric acid abnormal | 39.74 | 37.76 | 6 | 1639 | 156 | 90626646 |
FDA Adverse Event Reporting System (Male)
| MedDRA adverse event term | Likelihood ratio | Likelihood ratio threshold | Patients taking drug having adverse event | Patients taking drug not having adverse event | Patients not taking drug having adverse event | Patients not taking drug not having adverse event |
|---|---|---|---|---|---|---|
| Myalgia | 272.71 | 62.47 | 102 | 1127 | 95978 | 42524128 |
| Blood creatine phosphokinase increased | 146.01 | 62.47 | 54 | 1175 | 48284 | 42571822 |
FDA Adverse Event Reporting System (Geriatric)
| MedDRA adverse event term | Likelihood ratio | Likelihood ratio threshold | Patients taking drug having adverse event | Patients taking drug not having adverse event | Patients not taking drug having adverse event | Patients not taking drug not having adverse event |
|---|---|---|---|---|---|---|
| Myalgia | 444.48 | 41.30 | 164 | 1963 | 222217 | 110364955 |
| Blood creatine phosphokinase increased | 148.77 | 41.30 | 55 | 2072 | 73022 | 110514150 |
| Muscle rupture | 111.44 | 41.30 | 24 | 2103 | 4436 | 110582736 |
| Muscle spasms | 108.61 | 41.30 | 67 | 2060 | 278090 | 110309082 |
| Muscle discomfort | 53.08 | 41.30 | 9 | 2118 | 465 | 110586707 |
| Pain in extremity | 46.92 | 41.30 | 52 | 2075 | 487066 | 110100106 |
| Blood uric acid abnormal | 46.73 | 41.30 | 8 | 2119 | 438 | 110586734 |
| Dizziness | 45.29 | 41.30 | 61 | 2066 | 698132 | 109889040 |
FDA Adverse Event Reporting System (Pediatric)
None
Pharmacologic Action:
| Source | Code | Description |
|---|---|---|
| ATC | C10AX15 | CARDIOVASCULAR SYSTEM LIPID MODIFYING AGENTS LIPID MODIFYING AGENTS, PLAIN Other lipid modifying agents |
| ATC | C10BA10 | CARDIOVASCULAR SYSTEM LIPID MODIFYING AGENTS LIPID MODIFYING AGENTS, COMBINATIONS Combinations of various lipid modifying agents |
| MeSH PA | D000960 | Hypolipidemic Agents |
| MeSH PA | D000963 | Antimetabolites |
| MeSH PA | D004791 | Enzyme Inhibitors |
| MeSH PA | D007004 | Hypoglycemic Agents |
| MeSH PA | D057847 | Lipid Regulating Agents |
| FDA EPC | N0000193913 | Adenosine Triphosphate-Citrate Lyase Inhibitor |
| FDA MoA | N0000193914 | Adenosine Triphosphate-Citrate Lyase Inhibitors |
| CHEBI has role | CHEBI:35526 | hypoglycemic agent |
| CHEBI has role | CHEBI:35554 | cardiovascular drug |
| CHEBI has role | CHEBI:35679 | antilipemic drug |
| CHEBI has role | CHEBI:35821 | anticholesteremic drug |
| CHEBI has role | CHEBI:50266 | prodrug |
| CHEBI has role | CHEBI:145947 | antiatherosclerotic agent |
| CHEBI has role | CHEBI:149598 | EC 2.3.3.8 (ATP citrate synthase) inhibitor |
Related Drugs by ATC class:
C10AX Other lipid modifying agents 15 drugs
C10BA Combinations of various lipid modifying agents 9 drugs
Drug Use | Suggest Off label Use Form| |View source of the data|
| Disease | Relation | SNOMED_ID | DOID |
|---|---|---|---|
| Atherosclerotic occlusive disease | indication | 129573006 | |
| Familial hypercholesterolemia - heterozygous | indication | 238079002 |
🐶 Veterinary Drug Use
None
🐶 Veterinary products
None
Acid dissociation constants calculated using MoKa v3.0.0
| Dissociation level | Dissociation constant | Type (acidic/basic) |
|---|---|---|
| pKa1 | 4.87 | acidic |
| pKa2 | 5.47 | acidic |
Orange Book patent data (new drug applications)
| Formulation strength | Trade name | Applicant | Application number | Approval date | Type | Dose form | Route | Patent number | Patent expiration date | Patent use |
|---|---|---|---|---|---|---|---|---|---|---|
| 180MG | NEXLETOL | ESPERION THERAPS INC | N211616 | Feb. 21, 2020 | RX | TABLET | ORAL | 11744816 | March 14, 2036 | A METHOD OF LOWERING LDL-C OR REDUCING THE RISK OF CARDIOVASCULAR DISEASE IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA USING 180 MG BEMPEDOIC ACID AND 10 MG EZETIMIBE |
| 180MG;10MG | NEXLIZET | ESPERION THERAPS INC | N211617 | Feb. 26, 2020 | RX | TABLET | ORAL | 10912751 | March 14, 2036 | A METHOD OF LOWERING LDL-C OR REDUCING THE RISK OF CARDIOVASCULAR DISEASE IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA USING A FIXED-DOSE COMBINATION OF 180 MG BEMPEDOIC ACID AND 10 MG EZETIMIBE |
| 180MG;10MG | NEXLIZET | ESPERION THERAPS INC | N211617 | Feb. 26, 2020 | RX | TABLET | ORAL | 10912751 | March 14, 2036 | A METHOD OF TREATING HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA OR ESTABLISHED ATHEROSCLEROTIC CARDIOVASCULAR DISEASE BY DECREASING THE LEVEL OF LDL-C USING A FIXED DOSE COMBINATION OF 180 MG BEMPEDOIC ACID AND 10 MG EZETIMIBE |
| 180MG;10MG | NEXLIZET | ESPERION THERAPS INC | N211617 | Feb. 26, 2020 | RX | TABLET | ORAL | 11744816 | March 14, 2036 | A METHOD OF LOWERING LDL-C OR REDUCING THE RISK OF CARDIOVASCULAR DISEASE IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA USING 180 MG BEMPEDOIC ACID AND 10 MG EZETIMIBE |
| 180MG;10MG | NEXLIZET | ESPERION THERAPS INC | N211617 | Feb. 26, 2020 | RX | TABLET | ORAL | 11744816 | March 14, 2036 | A METHOD OF TREATING HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA OR ESTABLISHED ATHEROSCLEROTIC CARDIOVASCULAR DISEASE BY DECREASING THE LEVEL OF LDL-C USING 180 MG BEMPEDOIC ACID AND 10 MG EZETIMIBE |
| 180MG | NEXLETOL | ESPERION THERAPS INC | N211616 | Feb. 21, 2020 | RX | TABLET | ORAL | 11926584 | June 19, 2040 | A METHOD OF LOWERING LOW-DENSITY LIPOPROTEIN CHOLESTEROL (LDL-C) IN A HUMAN PATIENT IN NEED THEREOF COMPRISING ADMINISTRATION OF BEMPEDOIC ACID ALONE OR IN COMBINATION WITH OTHER LIPID LOWERING THERAPIES |
| 180MG | NEXLETOL | ESPERION THERAPS INC | N211616 | Feb. 21, 2020 | RX | TABLET | ORAL | 12404227 | June 19, 2040 | A METHOD OF TREATING PRIMARY HYPERLIPIDEMIA USING BEMPEDOIC ACID |
| 180MG;10MG | NEXLIZET | ESPERION THERAPS INC | N211617 | Feb. 26, 2020 | RX | TABLET | ORAL | 11926584 | June 19, 2040 | A METHOD OF LOWERING LOW-DENSITY LIPOPROTEIN CHOLESTEROL (LDL-C) IN A HUMAN PATIENT IN NEED THEREOF COMPRISING ADMINISTRATION OF BEMPEDOIC ACID ALONE OR IN COMBINATION WITH OTHER LIPID LOWERING THERAPIES |
| 180MG;10MG | NEXLIZET | ESPERION THERAPS INC | N211617 | Feb. 26, 2020 | RX | TABLET | ORAL | 12404227 | June 19, 2040 | A METHOD OF TREATING PRIMARY HYPERLIPIDEMIA USING BEMPEDOIC ACID |
Orange Book exclusivity data (new drug applications)
| Formulation strength | Trade name | Applicant | Application number | Approval date | Type | Dose form | Route | Exclusivity date | Description |
|---|---|---|---|---|---|---|---|---|---|
| 180MG | NEXLETOL | ESPERION THERAPS INC | N211616 | Feb. 21, 2020 | RX | TABLET | ORAL | March 22, 2027 | EXPANDED INDICATION FOR USE AS AN ADJUNCT TO DIET, IN COMBINATION WITH OTHER LOW-DENSITY LIPOPROTEIN CHOLESTEROL (LDL-C) LOWERING THERAPIES, OR ALONE WHEN CONCOMITANT LDL-C LOWERING THERAPY IS NOT POSSIBLE, TO REDUCE LDL-C IN ADULTS WITH PRIMARY HYPERLIPIDEMIA, INCLUDING HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA (HEFH) |
| 180MG | NEXLETOL | ESPERION THERAPS INC | N211616 | Feb. 21, 2020 | RX | TABLET | ORAL | March 22, 2027 | TO REDUCE THE RISK OF MYOCARDIAL INFARCTION AND CORONARY REVASCULARIZATION IN ADULTS WHO ARE UNABLE TO TAKE RECOMMENDED STATIN THERAPY (INCLUDING THOSE NOT TAKING A STATIN) WITH ESTABLISHED CARDIOVASCULAR DISEASE (CVD), OR AT HIGH RISK FOR A CVD EVENT BUT WITHOUT ESTABLISHED CVD |
| 180MG;10MG | NEXLIZET | ESPERION THERAPS INC | N211617 | Feb. 26, 2020 | RX | TABLET | ORAL | March 22, 2027 | EXPANDED INDICATION FOR USE AS AN ADJUNCT TO DIET, ALONE OR IN COMBINATION WITH OTHER LDL-C LOWERING THERAPIES, TO REDUCE LDL-C IN ADULTS WITH PRIMARY HYPERLIPIDEMIA, INCLUDING HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA (HEFH) |
| 180MG;10MG | NEXLIZET | ESPERION THERAPS INC | N211617 | Feb. 26, 2020 | RX | TABLET | ORAL | March 22, 2027 | TO REDUCE THE RISK OF MYOCARDIAL INFARCTION AND CORONARY REVASCULARIZATION IN ADULTS WHO ARE UNABLE TO TAKE RECOMMENDED STATIN THERAPY (INCLUDING THOSE NOT TAKING A STATIN) WITH ESTABLISHED CARDIOVASCULAR DISEASE (CVD), OR AT HIGH RISK FOR A CVD EVENT BUT WITHOUT ESTABLISHED CVD |
Bioactivity Summary:
| Target | Class | Pharos | UniProt | Action | Type | Activity value (-log[M]) | Mechanism action | Bioact source | MoA source |
|---|---|---|---|---|---|---|---|---|---|
| ATP-citrate synthase | Enzyme | INHIBITOR | Ki | 5.69 | SCIENTIFIC LITERATURE | DRUG LABEL |
External reference:
| ID | Source |
|---|---|
| 1EJ6Z6Q368 | UNII |
| 4039212 | VANDF |
| C3659310 | UMLSCUI |
| CHEBI:149601 | CHEBI |
| A1JTY | PDB_CHEM_ID |
| CHEMBL3545313 | ChEMBL_ID |
| 10472693 | PUBCHEM_CID |
| DB11936 | DRUGBANK_ID |
| 9891 | INN_ID |
| C581236 | MESH_SUPPLEMENTAL_RECORD_UI |
| D10691 | KEGG_DRUG |
| 8321 | IUPHAR_LIGAND_ID |
| 870523005 | SNOMEDCT_US |
| 870609002 | SNOMEDCT_US |
| 331395 | MMSL |
| 38188 | MMSL |
| d09518 | MMSL |
| 018287 | NDDF |
| 2282403 | RXNORM |
| 1EJ6Z6Q368 | INXIGHT DRUGS |
Pharmaceutical products:
| Product | Category | Ingredients | NDC | Form | Quantity | Route | Marketing | Label |
|---|---|---|---|---|---|---|---|---|
| Nexletol | HUMAN PRESCRIPTION DRUG LABEL | 1 | 72426-118 | TABLET, FILM COATED | 180 mg | ORAL | NDA | 31 sections |
| Nexlizet | HUMAN PRESCRIPTION DRUG LABEL | 2 | 72426-818 | TABLET, FILM COATED | 180 mg | ORAL | NDA | 31 sections |