Dear doctors and patients, Many a times in our clinical practice we see patients with dyslipidemia. They are on high dose of statins and still not reached their target levels. Some have adverse effects like myopathy and raised liver enzymes. Some patients are intolerant to even a small dose of statin. Some of them are having high LDL despite being on full dose statin+ezetimibe+- PCSK inhibitors. For all these patients a new molecule called bempedoic acid is launched in india recently. It is a ATP citrate lyase inhibitor and inhibits cholesterol synthesis by blocking this enzyme in the pathway. Dose is 180 mg per day. Its receptors exist in liver and kidney only. Hence there are no muscle related adverse effects. It causes drop in LDL c levels by 19 mg/ dl as reported in trials. Costs rs 20/ tablet. Current indications: As an add on therapy for ASCVD patients, heterozygous hepercholesterolemia patients who are uncontrolled with statins / statins + ezetimibe +pcski. As a monotherapy for patients intolerant to even low dose of statin. As an addon therapy for patients having adverse effects of high dose statins. No dose adjustments required in CKD and liver failure. However drug not studies in ESRD patients and child pugh c patients. Safety in pregnancy not known. Patients with severe dyslipidemia can visit clinic for further management. Dr Hardik Thakker, MD MED, ECFMG (USA).