PCSK9 INHIBITOR DOSING








Alirocumab (Praluent®)

Dosage forms

Single-dose prefilled pens
  • 75 mg/ml
  • 150 mg/ml
  • Comes in pack of 1 or 2 pens
Single-dose prefilled syringes
  • 75 mg/ml
  • 150 mg/ml
  • Comes in pack of 1 or 2 syringes

Dosing

Adults with established CVD or with primary hyperlipidemia including HeFH
  • Starting: 75 mg every 2 weeks OR 300 mg every 4 weeks
  • Maintenance: 75 - 150 mg every 2 weeks OR 300 mg every 4 weeks
  • Max: 150 mg every 2 weeks OR 300 mg every 4 weeks
  • May administer without regard to food
Adults with HeFH undergoing LDL apheresis or in adults with HoFH
  • Dosing: 150 mg every 2 weeks
  • May be administered without regard to the timing of LDL apheresis
Missed doses
  • If an every-2-week dose is missed, administer the injection within 7 days from the missed dose and resume the original schedule. If the missed dose is not administered within 7 days, wait until the next dose on the original schedule.
  • If an every-4-week dose is missed, administer the injection within 7 days from the missed dose and resume the original schedule. If the missed dose is not administered within 7 days, administer the dose, starting a new schedule based on this date.

Other

  • Allow syringe to warm to room temperature for 30 - 40 minutes before injecting
  • Inject subcutaneously into thigh, abdomen, or upper arm. Rotate injection sites.
  • Recheck LDL 4 - 8 weeks after starting therapy and after dose changes. For patients receiving 300 mg every 4 weeks, check LDL just prior to the next scheduled dose since LDL levels can vary widely on this dosing regimen.
  • To administer the 300 mg dose, give two 150 mg injections consecutively at two different injection sites
  • Do not expose to direct sunlight
  • Do not shake syringes or pens

Generic / Price

- NO/$$$$

Storage

  • Store unused pens in a refrigerator
  • If needed, Praluent may be kept at room temperature up to 77°F (25°C) for a maximum of 30 days in original carton to protect from light

Evolocumab (Repatha®)

Dosage forms

Single-use prefilled syringe
  • 140 mg/ml
  • Comes in pack of one syringe
Single-use prefilled autoinjector
  • 140 mg/ml
  • Comes in packs of 1, 2, or 3 injectors
Single-use on-body infuser (Pushtronex® System)
  • 420 mg/3.5 ml
  • Infuses drug subcutaneously over 5 minutes

Dosing

Established CVD or primary hyperlipidemia (adults)
  • Dosing: 140 mg every 2 weeks OR 420 mg once monthly
  • If switching dosage regimens, administer the first dose of the new regimen on the next scheduled date of the prior regimen
  • The LDL-lowering effect of evolocumab may be measured as early as 4 weeks after initiation. LDL can vary during the dosing interval in some patients; recommend measuring LDL just prior to the next scheduled dose.
HeFH in pediatric patients aged 10 years and older
  • Dosing: 140 mg every 2 weeks OR 420 mg once monthly
  • If switching dosage regimens, administer the first dose of the new regimen on the next scheduled date of the prior regimen
  • The LDL-lowering effect of evolocumab may be measured as early as 4 weeks after initiation. LDL can vary during the dosing interval in some patients; recommend measuring LDL just prior to the next scheduled dose.
HoFH in pediatric patients aged 10 years and older and adults
  • Starting: 420 mg once monthly
  • The dosage can be increased to 420 mg every 2 weeks if a clinically meaningful response is not achieved in 12 weeks
  • Patients on lipid apheresis may initiate treatment with 420 mg every 2 weeks to correspond with their apheresis schedule. Administer evolocumab after the apheresis session is complete.
  • The LDL-lowering effect of evolocumab may be measured as early as 4 weeks after initiation. LDL can vary during the dosing interval in some patients; recommend measuring LDL just prior to the next scheduled dose.
Missed doses
  • Still within 7 days of the missed dose
    • Administer evolocumab and resume original schedule
  • More than 7 days after missed dose
    • Every 2-week dosing - wait until the next dose on the original schedule
    • Once monthly dosing - administer the dose and start a new schedule based on this date

Other

  • Dose is given by subcutaneous injection in the abdomen, thigh, or upper arm
  • Dose may be given without regard to food
  • To administer the 420 mg dose, give 3 injections consecutively within 30 minutes or use the on-body infuser. Choose a different injection site with each injection.
  • Prior to use, allow to warm to room temperature for at least 30 minutes for the autoinjector or syringe and for at least 45 minutes for the on-body infusor
  • Do not expose to direct sunlight
  • Do not shake syringes or injectors

Generic / Price

- NO/$$$$

Storage

  • Store in refrigerator
  • May be kept at room temperature for a maximum of 30 days
  • Do not expose to temperatures above 25°C (77°F)







Pricing legend
  • $ = 0 - $50
  • $$ = $51 - $100
  • $$$ = $101 - $150
  • $$$$ = > $150
  • Pricing based on one month of therapy at standard dosing in an adult
  • Pricing based on information from GoodRX.com®
  • Pricing may vary by region and availability

Patient Assistance Programs for PCSK9 inhibitors
Drug Manufacturer Ships to PAP info Application
Alirocumab (Praluent®) Regeneron Patient or pharmacy Link Link
Evolocumab (Repatha®) Amgen Patient Link Link