Can you identify these medications for dyslipidemia ? To find out, match each brand name in Section I with its generic name in Section II.

Section I.

______ 1. Nexletol (Esperion Therapeutics Inc.)

______ 2. Repatha (Amgen Inc.)

______ 3. Nexlizet (Esperion Therapeutics Inc.)

Section II.

a. evolocumab.1 This injectable agent is a human monoclonal antibody proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitor. It should be used in patients that are unable to meet their cholesterol goals with diet modification and other agents such as maximum dose statin therapy. Dosing for primary hyperlipidemia is 140 mg subcutaneously every 2 weeks or 420 mg once monthly. If a dose is missed within 7 days from the original schedule, patients should be instructed to administer the missed dose and then resume the original schedule with the next dose. If a dose is missed by more than 7 days of a 2-week dosing schedule, patients should be instructed to wait until the next dose is due; monthly dose can be administered if missed, and patients should be instructed to start a new administration date based on when the dose is given. Allow the dose to remain at room temperature for at least 30 to 45 minutes depending on formulation prior to administration.

b. bempedoic acid.2 This drug is an adenosine triphosphate-citrate lyase (ACL) inhibitor that lowers LDL cholesterol. ACL is an enzyme upstream in the cholesterol biosynthesis pathway from HMG-CoA reductase. It should be used in combination with maximum statin therapy. The dosing is 180 mg orally once daily, taken without regard to food. Significant adverse effects include hyperuricemia and tendon rupture. This medication should not be used concomitantly with simvastatin (doses greater than 20 mg per day) or pravastatin (doses greater than 40 mg per day) to avoid statin-related myopathy. Lipid levels and uric acid levels should be monitored.

c. bempedoic acid/ezetimibe.3 This agent is a combination of an ACL inhibitor and a 2-azetidinone agent. Ezetimibe inhibits absorption through the sterol transporter at the small intestine which leads to a decreased delivery of cholesterol to the liver. The oral combination agent consists of 180 mg of bempedoic acid and 10 mg of ezetimibe. The dose is 1 tablet daily in combination with the maximum dose of statin therapy. The tablet must be swallowed whole and can be taken without regard to food. Hyperuricemia and tendon rupture have been reported as significant adverse effects. Patients should be instructed to avoid concomitant use of simvastatin (doses greater than 20 mg per day) or pravastatin (doses greater than 40 mg per day).

Answers: 1. B, 2. A, 3. C

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