alirocumab
Brand: Praluent
Prototype: evolocumab
Drug Class: PCSK9 inhibitor
Drug Family: antilipemic
Subclass: fully human monoclonal antibody (IgG1)
Organ Systems: cardiovascular
Mechanism of Action
Inhibits PCSK9 preventing LDL receptor degradation; similar mechanism to evolocumab.
PCSK9
Indications
- ASCVD (secondary prevention)
- heterozygous familial hypercholesterolemia
- LDL reduction uncontrolled on statins
Contraindications
Adverse Effects
Common
- injection site reactions
- nasopharyngitis
- myalgia
Serious
- neurocognitive effects (uncertain causality)
Pharmacokinetics (ADME)
| Absorption | 85% SC bioavailability |
| Distribution | moderate |
| Metabolism | proteolytic/target-mediated |
| Excretion | degradation |
| Half-life | ~17-20 days |
| Onset | 3-7 days |
| Peak | 3-7 days |
| Duration | 2-4 weeks |
| Protein Binding | <0% |
| Vd | SC |
Drug Interactions
| Drug / Agent | Mechanism | Severity |
|---|---|---|
| statins | additive LDL lowering | beneficial |
Nursing Considerations
- ODYSSEY OUTCOMES: reduced CV events in post-ACS patients
- SC injection q2 weeks (75-150 mg) or monthly (300 mg)
- Store refrigerated; warm to room temp 30-40 min before injection
Clinical Pearls
- ODYSSEY OUTCOMES: alirocumab reduced CV events and all-cause mortality in post-ACS on background statin
- First PCSK9 inhibitor to show mortality reduction
Safety Profile
Pregnancy avoid
Lactation insufficient-data
Renal Adjustment Not required
Hepatic Adjustment Not required
TDM Not required
Guideline Update pending
Concordance Terms
Cross-referenced clinical concepts — click any term to see all content where it appears.