Gout from Bempedoic Acid: Causes, Risks, and What to Do
When you take bempedoic acid, a cholesterol-lowering drug prescribed for people who can’t tolerate statins or need extra help lowering LDL. It works by blocking an enzyme in the liver that makes cholesterol, and it’s been shown to cut heart attack risk in high-risk patients. But there’s a side effect many don’t talk about: gout, a painful form of arthritis caused by uric acid crystals building up in joints. Studies show about 2% to 5% of people on bempedoic acid develop gout—often within the first few months. That’s higher than with statins, and it’s not just bad luck. It’s biology.
Here’s why it happens: bempedoic acid reduces cholesterol, but it also changes how your body clears uric acid. Your kidneys start holding onto more of it, and levels rise. That’s called hyperuricemia, the medical term for too much uric acid in the blood. When uric acid hits a certain point, it forms sharp crystals in your big toe, ankle, or knee. The pain hits fast—burning, swollen, so bad you can’t even wear socks. And if you’ve had gout before, bempedoic acid can make it come back harder.
But you don’t have to quit bempedoic acid if you get gout. Many people keep taking it and manage the flare-ups with simple fixes. Drinking more water helps flush out uric acid. Cutting back on red meat, shellfish, and beer cuts the trigger. Some doctors add a low-dose colchicine, a medication used to prevent and treat gout attacks as a precaution, especially if you’re at high risk. It’s not a cure, but it stops flares before they start. And if your gout keeps coming back, your doctor might switch you to another cholesterol drug—but only after weighing the heart benefits against the joint pain.
This isn’t just about one drug. It’s about how medications affect your whole body. Bempedoic acid helps your heart, but it can stress your joints. That’s why knowing the signs matters. If your toe suddenly swells up after starting this pill, don’t ignore it. Call your doctor. Get your uric acid levels checked. You might need a small change in your plan, not a big one. And if you’re on bempedoic acid and haven’t thought about gout yet, now’s the time. Ask your pharmacist or doctor: "Could this be triggering gout for me?" It’s a simple question that can save you months of pain.
Below, you’ll find real patient experiences, clinical insights, and practical steps to manage gout while staying on the medication that keeps your heart safe. No fluff. Just what works.
Bempedoic Acid Side Effects: Gout, Tendon Risks, and What You Need to Know
Dec, 2 2025