Gout from Bempedoic Acid: What You Need to Know About This Rare Side Effect

When you take bempedoic acid, a cholesterol-lowering drug prescribed for people who can’t tolerate statins or need extra help controlling LDL. It works in the liver to block an enzyme that makes cholesterol, and it’s often used alongside other heart medications. But for some, it doesn’t just lower cholesterol—it can trigger gout, a painful form of arthritis caused by uric acid crystals building up in joints. This isn’t common, but it’s real enough that doctors now track it as a known side effect. If you’ve started bempedoic acid and suddenly feel sharp pain in your big toe, ankle, or knee, it might not be a coincidence.

Hyperuricemia, the medical term for high levels of uric acid in the blood is the link. Bempedoic acid reduces the body’s ability to clear uric acid, causing it to build up. Over time, those crystals form in joints, leading to swelling, redness, and intense pain—classic signs of a gout flare. People with a history of gout, kidney problems, or who already have high uric acid are at higher risk. It’s not an allergy. It’s a metabolic shift. And unlike statins, which rarely cause this, bempedoic acid has a clear signal in clinical trials: about 1 in 20 users develop gout within the first year.

That doesn’t mean you should stop taking it. Many people use bempedoic acid safely for years. But if you’re on it, watch for early signs: sudden joint pain, especially at night, or swelling that comes on fast. Talk to your doctor. They might check your uric acid levels, suggest drinking more water, or add a low-dose colchicine to prevent flares. Some switch to other cholesterol drugs if gout becomes a problem. The goal isn’t to avoid bempedoic acid entirely—it’s to use it smartly. You’re not alone if this happens. It’s a known trade-off for better heart health.

Below, you’ll find real-world advice from people who’ve dealt with this side effect, plus guides on managing gout triggers, understanding how medications affect your kidneys, and spotting when a reaction is more than just discomfort. These aren’t just theory pieces—they’re practical, tested tips from patients and doctors who’ve been there.