Guidelines and precautions for the use of Nexletol by Otsuka Pharmaceutical in the treatment of hypercholesterolemia in Japan
Nexletol is an innovative oral medication for treating hypercholesterolemia, which reduces LDL-C by inhibiting ATP citrate lyase. The standard dose is 180mg daily taken with meals. Attention should be paid to monitoring liver function and adverse reactions such as muscle pain, especially for patients with statin intolerance. The clinical lipid-lowering effect is significant and the safety is good.
1. Medication Guide
(1) Dosage and administration: Take 180mg orally at a fixed time daily, and it must be taken with meals to improve bioavailability. The whole tablet should be swallowed without splitting or chewing.
(2) Course management: Continuous medication for 12 weeks can achieve maximum efficacy, and long-term treatment requires evaluation of blood lipid indicators and safety parameters every 6 months.
(3) Omission treatment: If a missed dose is found on the same day, it should be immediately replenished. If it is close to the next medication time, it should be skipped, and double dose compensation is prohibited.
2 Precautions
(1) Liver function monitoring: ALT should be tested before and 12 weeks after treatment. If the ULN continues to be greater than 3 times, the medication should be stopped. Patients with severe liver injury should not use it.
(2) Muscle symptoms: When combined with statins, be alert to muscle pain or weakness. If unexplained muscle pain occurs, seek medical evaluation immediately.
(3) Uric acid management: It may increase blood uric acid levels by 1-2mg/dL. Gout patients need to strengthen monitoring and undergo uric acid lowering treatment if necessary.
3 Special populations
(1) Elderly patients: Patients aged 65 and above do not need to adjust their dosage, but due to an increase in concomitant medications, it is necessary to strengthen adverse reaction monitoring.
(2) Liver and kidney function: Mild to moderate liver damage and any degree of kidney damage do not require dose adjustment, but monitoring intervals need to be extended.
(3) Pregnancy and lactation: Women of childbearing age should take contraceptive measures, suspend breastfeeding during lactation, and only use it during pregnancy when the benefits are clear.
4 Drug Interactions
(1) Statins: Combination with rosuvastatin may increase the exposure of the latter, and it is recommended to adjust the dosage of statins.
(2) Transporter inhibitors: Combination with OATP1B1 inhibitors may increase the blood concentration of beperidone, and caution should be exercised when using it in combination.
(3) Antacid medication: Aluminum/magnesium containing antacids should be taken every 2 hours to avoid reducing the absorption rate of beperidol.
Disclaimer：《Guidelines and precautions for the use of Nexletol by Otsuka Pharmaceutical in the treatment of hypercholesterolemia in Japan》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！