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Tendon and nerve damage due to Bempedoic acid in Nexletol

Posted by bengaltigre @bengaltigre, May 28 8:18am

I am a 69yr old woman with Type 2 Diabetes. I was on Nexletol the cholesterol medicine for 3.5 months. By Aug 2025 I had tendon rupture on my left leg and heel. Fortunately it was not the Achilles tendon but almost a year later I am still in some pain esp in the ankle and heel. Unfortunately none of my docs connected the meds with the tendon and they gave me a similar med in Mar 2026 upon which I noticed nerve tingling in my left arm and eye and immediately made the meds connection and stopped taking it after 2 weeks. Apparently tendon rupture is a severe side effect of the Bempedoic acid in Nexletol. It has been 2 mths since and the nerve damage seems to have spead to my face. I can feel the nerves in my right eye also twitching and every time I go to the dentist my nerves in my gums are also inflammed. My B & D Vitamin levels are good. I walk everyday although my heel is still painful even though bone spurs are not visible on the CT scan. The recent nerve tingling on my arm is the one that is bothering me now as it interferes with my sleep as its always on pins and needles. I am doing everything I can with food and activity. What can I do to heal faster? All help is appreciated!

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Janell, Volunteer Mentor | @jlharsh | Jul 15 6:28pm

Hi @bengaltigre, welcome to Mayo Clinic Connect. I’m sorry to hear about everything you’ve been dealing with. It sounds especially frustrating that you’re still having heel pain almost a year later and are now experiencing persistent pins-and-needles sensations and tingling that seem to be affecting other areas as well.

It sounds like you’ve already taken an important step by stopping the medication and working on healthy lifestyle changes. Since your symptoms are continuing and you’ve noticed new areas becoming involved, I think it’s important to let the healthcare team managing your care know about those changes if you haven’t already. They can help determine whether additional evaluation is needed and discuss the best approach for treating the nerve symptoms while you recover.

I’m glad you reached out here because there may be others who have had tendon problems or nerve symptoms while taking cholesterol-lowering medications and can share their experiences.

I’m wondering, have you been evaluated by a neurologist for the pins-and-needles sensations, or has your primary care clinician discussed whether nerve testing (such as an EMG or nerve conduction study) would be helpful? And has anyone on your care team reported these side effects as a possible medication reaction?

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bengaltigre | @bengaltigre | Jul 16 6:05am
In reply to @jlharsh "Hi @bengaltigre, welcome to Mayo Clinic Connect. I’m sorry to hear about everything you’ve been dealing..." + (show)
Profile picture for Janell, Volunteer Mentor @jlharsh

Hi @bengaltigre, welcome to Mayo Clinic Connect. I’m sorry to hear about everything you’ve been dealing with. It sounds especially frustrating that you’re still having heel pain almost a year later and are now experiencing persistent pins-and-needles sensations and tingling that seem to be affecting other areas as well.

It sounds like you’ve already taken an important step by stopping the medication and working on healthy lifestyle changes. Since your symptoms are continuing and you’ve noticed new areas becoming involved, I think it’s important to let the healthcare team managing your care know about those changes if you haven’t already. They can help determine whether additional evaluation is needed and discuss the best approach for treating the nerve symptoms while you recover.

I’m glad you reached out here because there may be others who have had tendon problems or nerve symptoms while taking cholesterol-lowering medications and can share their experiences.

I’m wondering, have you been evaluated by a neurologist for the pins-and-needles sensations, or has your primary care clinician discussed whether nerve testing (such as an EMG or nerve conduction study) would be helpful? And has anyone on your care team reported these side effects as a possible medication reaction?

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@jlharsh thank you so much for your response! I am now in Italy for the summer and I am getting better everyday. Apparently walking on cobblestones is therapeutic for the heels who knew?! I have spoken to several doctors and specialists and they all agree it is the side effect of the medication. I notice that every cholesterol med over the years has given me problems. Hopefully I can get the new yearly cholesterol med that is waiting for approval on! Having tried all alternate treatments like Chiro PT Ortho etc. the only one that seems to give me more relief is accupuncture! I never believed in it before but every time my entire left leg starts hurting I get accupuncture and it alleviates the pain for 2-3 weeks! Tingling on left hand and forearm is much better and no more eye and mouth twitching. At the end of July it will be 1 year since this started! It's very annoying but I am an extremely resilient person and I know I will get through this! Thanks for connecting I appreciate it greatly!

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