alirocumab (Praluent)

Alirocumab is a man-made injectable drug that reduces cholesterol levels in the blood. It is the first member of a new class of drugs called proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors. Cholesterol is carried in the blood to a large extent by particles of low density lipoproteins that are removed from the blood by liver cells. The particles are removed from the blood by low-density lipoprotein receptors (LDLR) on liver cells. PCSK9 is a protein on liver cells that promotes the destruction of LDLR. Therefore, a decrease in LDLR levels by PCSK9 results in higher blood levels of LDL cholesterol.

Alirocumab is an antibody, which means that it is a protein that binds to another protein and inactivates it. Alirocumab binds to the PCSK9 protein and prevents it from destroying LDLR. By inhibiting PCSK9, Alirocumab increases the number of LDLRs available to remove LDL cholesterol and consequently reduces LDL cholesterol levels in blood. The FDA approved alirocumab in July 2015.

What brand names are available for alirocumab?

Praluent

Is alirocumab available as a generic drug?

No

Do I need a prescription for alirocumab?

Yes

The most common side effects associated with alirocumab treatment include

• injection site reactions,
• symptoms of the common cold, and
• flu-like symptoms.

Other side effects include

• diarrhea,
• muscle pain,
• muscle spasms, and
• urinary tract infections (UTIs).

Liver problems were reported in 2.5% of patients treated with alirocumab compared to 1.8% in patients treated with placebo.

The recommended starting dose of alirocumab is 75 mg via subcutaneous injection (into the fat layer underneath the skin) every 2 weeks. If the LDL cholesterol lowering response is not adequate with this starting dose, the dosage may be increased to a maximum dosage of 150 mg every 2 weeks. LDL cholesterol levels should be measured within 4 to 8 weeks of starting therapy to assess response to treatment, and a decision should be made whether or not to adjust the dose.

Alirocumab should only be injected by subcutaneous injection into the thigh, abdomen, or upper arm. Injection sites should be rotated with each injection to prevent or reduce injection site reactions and irritation. Alirocumab should not be co-administered with other injectable drugs at the same injection site.

No clinically significant drug-drug interactions are listed for alirocumab.

There is no data on the use of alirocumab in pregnant women.

It is not known if alirocumab can enter human milk or cause harm to the nursing infant.

What preparations of alirocumab are available?

Single dose pre-filled pens and single-dose pre-filled glass syringes, each designed to deliver 1 ml of 75 mg/ml or 150 mg/ml.

How should I keep alirocumab stored?

Alirocumab should be stored in the refrigerator at 2 C to 8 C (36 F to 46 F) and protected from light and extreme heat. It should not be frozen.