Praluent (Alirocumab) - Subcutaneous

What Is Praluent?

Praluent (alirocumab) is a prescription injectable medication used to lower bad cholesterol and reduce the risk of heart attack, stroke, and chest pain in certain adults with heart disease.

Praluent is a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor. It works by blocking the PCSK9 protein, which improves the liver’s ability to clear bad cholesterol from circulation.

Praluent is taken by injecting it under your skin (subcutaneous).

Drug Facts

Generic Name: Alirocumab

Brand Name(s): Praluent

Drug Availability: Prescription

Therapeutic Classification: Antihyperlipidemic

Available Generically: No

Controlled Substance: N/A

Administration Route: Subcutaneous

Active Ingredient: Alirocumab

Dosage Form(s): Solution for injection

What Is Praluent Used For?

The Food and Drug Administration (FDA) approved Praluent to:

  • Decrease the risk of heart attack, stroke, and chest pain in some adults with heart disease, when used with a healthy diet.
  • Treat high cholesterol by reducing the bad cholesterol (low-density lipoprotein, or LDL) in your body. It is used alone or in combination with other cholesterol-lowering medication and in addition to a healthy diet.
  • Treat type of familial or inherited condition of high cholesterol called familial hypercholesterolemia, which is a genetic disorder that makes your cholesterol levels dangerously high. It is used in combination with other cholesterol-lowering therapies.

Praluent works by binding to and blocking the PCSK9 protein, improving your liver’s ability to clear bad cholesterol from blood circulation. Your healthcare provider may give you Praluent with other medications, such as statins or Zetia (ezetimibe), to lower your cholesterol.

How to Take Praluent

Follow your prescriber’s directions exactly on how to take Praluent. Do not take this medicine in larger or smaller amounts unless your healthcare provider instructs you.

Praluent comes as a ready-to-use pre-filled pen or pre-filled syringe. You can inject Praluent under your skin (subcutaneously) around the thighs, upper arms, and belly area. You will administer it every two or four weeks, depending on your condition.

If your healthcare provider gives you a monthly dose, do not inject all doses in one single shot. Instead, you should give yourself two separate injections in a row, using a different pen for each. In addition, you should change where you will inject the medication each time to avoid scarring that may affect the medication's absorption.

Talk to your healthcare provider if you have questions about using the medication.

Storage

You can store Praluent in a refrigerator at 36 F to 46 F (2 C to 8 C) in the original package until the expiration date. Do not freeze or shake. You can keep Praluent at room temperature up to 77 F (25 C) in the original package for up to 30 days. However, do not use it after leaving it at room temperature for 30 days. Keep Praluent out of the reach of children and any pets.

If you store Praluent in a refrigerator, let it warm to room temperature for at least 30 minutes before using it. This will help you feel less pain and itching when you inject the medication. 

How Long Does Praluent Take to Work?

Clinical studies have shown that it will take from three to seven days to four weeks for your cholesterol to decrease after starting Praluent.

What Are the Side Effects of Praluent?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Praluent include:

  • Cold symptoms such as runny nose, stuffy nose, or tiredness
  • Itching, redness, swelling, or pain at the injection site

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Allergic reactions can occur with Praluent. Symptoms may include hives, serious skin rash, trouble breathing, face swelling, tongue swelling, or throat swelling.

Report Side Effects

Praluent may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Praluent Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form:
    • For primary hyperlipidemia and lowering the risk of heart attack, stroke, and chest pain:
      • Adults—
        • Every 2-week dose: 75 milligrams (mg) injected under your skin once every 2 weeks. Your doctor may increase your dose as needed. However, the dose is usually not more than 150 mg injected under your skin once every 2 weeks.
        • Every 4-week dose: 300 mg injected under your skin once every 4 weeks, given as two 150 mg injections at two different sites. Your doctor may adjust your dose as needed. However, the dose is usually not more than 150 mg injected under your skin once every 2 weeks.
      • Children—Use and dose must be determined by your doctor.
    • For homozygous familial hypercholesterolemia:
      • Adults—150 milligrams (mg) injected under your skin once every 2 weeks.
      • Children—Use and dose must be determined by your doctor.

Modifications

Speak with your healthcare provider if you have any questions on dosage or use. It is generally safe to take this medication at a regular dose even if you have mild or moderate kidney or liver problems or are older than 65. Talk to your healthcare provider before you start or stop the medication or if you suspect a dose adjustment is needed.

There is limited information proving Praluent's safety and effectiveness in children.

If you are pregnant or plan to become pregnant soon, speak with your healthcare provider to see if Praluent is safe for you to take.

Missed Dose

If you miss a dose, but it is still within seven days, inject your missed dose as soon as you remember. Inject your next dose on your regular schedule (two weeks from the day you missed the dose if you inject every two weeks or four weeks from the day if you inject every four weeks).

If you miss a dose by more than seven days, wait until your next scheduled dose to restart. Do not take two doses simultaneously, as it may lead to overdose. Ask your healthcare provider if you have questions about when or how to restart Praluent.

Overdose: What Happens If I Take Too Much Praluent?

If you take too much Praluent, call your healthcare provider or immediately go to the nearest urgent care center or hospital emergency room.

What Happens If I Overdose on Praluent

If you think you or someone else may have overdosed on Praluent, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Praluent, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress within 4 to 8 weeks of using this medicine. This will allow your doctor to see if the medicine is working properly to lower your cholesterol levels and to decide if you should continue to use it. Blood tests may be needed to check for unwanted effects.

Serious allergic reactions (eg, angioedema, vasculitis) may occur while you are using this medicine. Tell your doctor right away if you have a rash, itching skin, difficulty with breathing or swallowing, fever, hives, sores, welting, or blisters, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, nausea, reddening of the skin, especially around the ears, swelling of the eyes, face, or inside of the nose, or unusual tiredness or weakness.

What Are Reasons I Shouldn’t Take Praluent?

You should not take Praluent:

  • If you are allergic to any ingredient in Praluent
  • If you are under age 18 years of age

What Other Medications Interact With Praluent?

Praluent is generally safe if taken with other medications. Ask your healthcare provider if you have any questions regarding drug interactions with Praluent.

What Medications Are Similar?

Currently, there are two medications under the PCSK9 inhibitor class:

Your healthcare provider may prescribe other medications to reduce your bad cholesterol level, such as:

Statins decrease cholesterol production in your liver, whereas ezetimibe decreases cholesterol absorption in the gut.

The above list does not contain every medication available used to decrease cholesterol levels. Talk to your healthcare provider about your treatment options.

Frequently Asked Questions

  • Can I take Praluent with a statin?

    Yes, you can take Praluent with or without a statin medication. Statin medications include:

    • Lipitor (atorvastatin)
    • Crestor (rosuvastatin)
    • Zocor (simvastatin)
    • Lescol (fluvastatin)
    • Lipostat (pravastatin)
  • Is Praluent a statin?

    No, even though Praluent and statins help reduce bad cholesterol levels in your body, they are not the same medication. Praluent is a PCSK9 inhibitor. It blocks the PCSK9 protein and helps your liver clear away bad cholesterol. Statins help decrease the production of cholesterol.

  • What's the difference between Praluent and Repatha?

    Praluent (alirocumab) and Repatha (evolocumab) are both injectable PCSK9 inhibitors. They are quite similar, but Praluent can only be used to treat adults, whereas Repatha can also treat children over 10 with familial hypercholesterolemia.

  • Is there a way to help me afford Praluent?

    Praluent may be expensive because there is no lower-cost generic of Praluent currently available. Patient Assistance Programs may be able to help with cost savings. Contact your healthcare provider for more information about your options.

    You may be able to reduce costs from a savings program through the manufacturer’s website, as some manufacturers offer copay assistance to make their medication more affordable.

How Can I Stay Healthy While Taking Praluent?

Take Praluent exactly as directed by your healthcare provider. Do not stop or change the dose before your healthcare provider tells you. It is important to take it regularly every two or four weeks based on your condition. 

Watch out for any signs of allergic reaction such as serious skin rash, trouble breathing, face swelling, tongue swelling, or throat swelling. Call your healthcare provider or go to the emergency department right away if you notice any of these symptoms.

It is also recommended to eat foods that help increase good cholesterol (high-density lipoprotein) and decrease bad cholesterol. Generally, it is recommended to limit saturated and trans fats, and eat foods high in soluble fiber, such as whole-grain cereals, fruits, and legumes. Talk to a dietitian or healthcare provider to tailor your diet modifications based on your condition and overall health.

Make sure you tell your healthcare provider all the medications you are taking, including prescription or over-the-counter (OTC) medications, vitamins, and herbal products before you start the treatment. 

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

The author would like to recognize and thank Yufeng Zhai for contributing to this article.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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