III. Indications

  1. Severe familial Hypercholesterolemia (e.g. LDL Cholesterol >190 mg/dl)

IV. Dosing

  1. Store in refrigerator at 36 to 46 degrees
    1. May also store in original carton up to 30 days at room Temperature <77 F
  2. Administer subcutaneously in the Abdomen, back of the upper arm or the thigh
    1. Warm to room Temperature for 30 to 40 minutes before use
    2. Administration of full dose may require 10 to 20 seconds
  3. Start 75 mg SC every 2 weeks
  4. Maximum
    1. Every 2 weeks: 150 mg SC
    2. Every 4 weeks: 300 mg SC (2 doses injected at different sites)

V. Efficacy

  1. See PCSK9 Inhibitor
  2. Lower LDL Cholesterol up to 45 to 48% when added to a Statin

VI. Disadvantages

  1. See PCSK9 Inhibitor
  2. Costs $450 per 2 weeks (>$10,000 per year) in 2022

VII. Safety

  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation

IX. References

  1. (2015) Presc Lett 22(9): 50-1
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  3. (2022) Non-StatinLipid Lowering Agents, Presc Lett, #380202
  4. (2022) Med Lett Drug Ther 64(1659): 145-52
  5. Robinson (2015) N Engl J Med 372(16):1489-99 +PMID:25773378 [PubMed]
  6. Stroes (2014) J Am Coll Cardiol 63(23):2541-8 [PubMed]

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Cost: Medications

praluent (on 7/15/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PRALUENT 150 MG/ML PEN $231.30 per ml
PRALUENT 75 MG/ML PEN $231.11 per ml