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Praluent vs Repatha

Drug facts and comparison

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Medically reviewed by  Jamie Winn, PharmD

Uses

  • Help reduce high ‘bad’ cholesterol when used alongside diet changes
  • Reduce high ‘bad’ cholesterol caused by heterozygous familial hypercholesterolemia
  • Reduce the risk of heart attacks, strokes, and a type of chest pain called unstable angina in adults with cardiovascular disease

 

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  • Lower bad cholesterol (LDL) levels in adults whose LDL levels are too high (primary hyperlipidemia)
  • Lower bad cholesterol (LDL) levels in adults and children over 13 years of age who have homozygous familial hypercholesterolemia
  • Lower the risk of heart attacks, strokes, and the need for unstable angina or coronary revascularization surgery in adults with cardiovascular disease
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Summary

Brand name: Praluent
Brand name: Repatha
Manufacturer: Regeneron and Sanofi
Manufacturer: Amgen
Active ingredient: alirocumab
Active ingredient: evolocumab
Indication: Help reduce high ‘bad’ cholesterol when used alongside diet changes. Reduce high ‘bad’ cholesterol caused by heterozygous familial hypercholesterolemia. Reduce the risk of heart attacks, strokes, and a type of chest pain called unstable angina in adults with cardiovascular disease.
Indication: Lower bad cholesterol (LDL) levels in adults whose LDL levels are too high (primary hyperlipidemia). Lower bad cholesterol (LDL) levels in adults and children over 13 years of age who have homozygous familial hypercholesterolemia. Lower the risk of heart attacks, strokes, and the need for unstable angina or coronary revascularization surgery in adults with cardiovascular disease.

Side Effects

Most common

  • Reactions at the site of injection, including redness, itching, swelling, tenderness, and pain
  • Common cold symptoms
  • Flu-like symptoms

Most common

  • Injection site reactions, like redness, bruising, and pain
  • A runny nose
  • A sore throat
  • Common cold symptoms
  • Flu symptoms
  • Back pain

More serious

  • Severe allergic reactions to the medication
  • Diabetes – high blood sugar levels (a common, but serious side effect)

Drug Interactions

Severe interaction

None

Serious interaction

None

Moderate interaction

None

Severe interactions

None

Serious interactions

None

Moderate interactions

None

Warnings

You should not use Praluent if you:

  • Are allergic to the active ingredient alirocumab
  • Are allergic to any of the other ingredients in Praluent
  • Are under 18 years of age

You should talk to your doctor before using Praluent if you:

  • Have any liver problems
  • Have any kidney problems
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

You should not use Repatha if you:

  • Are allergic to the active ingredient evolocumab
  • Are allergic to any of the other ingredients in Repatha
  • Are under 18 years of age to treat cardiovascular disease
  • Are under 18 years of age to treat primary hyperlipidemia
  • Are under 13 years to treat homozygous familial hypercholesterolemia

You should talk to your doctor before using Repatha if you:

  • Have any liver problems
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed
  • Are allergic to latex or rubber, as the needle cover of the prefilled syringe and the prefilled autoinjector contain rubber derived from latex

Dosage

Once every 2 weeks

Once, every 2 weeks

Cost

A single 1 ml self-injecting pen, 75 mg or 150 mg Praluent solution will cost around $800

2 single-use prefilled syringes, 140 mg/ml strength, will cost around $875

FAQs

Praluent and Repatha are called PCSK9 (proprotein convertase subtilisin Kexin type 9) inhibitors. They are a new class of cholesterol-lowering medications that are injected directly into the skin. Repatha is manufactured by the pharmaceutical company Amgen. Praluent is manufactured by Sanofi and Regeneron Pharmaceuticals.

Statins such as rosuvastatin (Crestor), atorvastatin (Lipitor), and simvastatin (Zocor) have been available for a long time to treat high cholesterol. Now, newer drugs like Praluent and Repatha can be used alongside statin therapy to achieve lower cholesterol in patients.

How does Repatha compare with Praluent? Let us take a look at the similarities and differences between these two cholesterol drugs.

How do Praluent and Repatha work?

Repatha contains the active drug evolocumab, which belongs to a class of medications known as PCSK9 inhibitors.

Praluent contains the active drug alirocumab, which is also a PCSK9 inhibitor.

Repatha and Praluent work by blocking PCSK9, which means more receptors are available to remove LDL-C (low-density lipoprotein cholesterol) from the blood. This results in lower LDL cholesterol levels. LDL_C is sometimes described as bad cholesterol because it collects in the walls of the arteries leading to your heart. HDL (high-density lipoprotein cholesterol) is known as good cholesterol because it takes cholesterol away from the heart.

Lowering LDL-C cholesterol reduces your risk of cardiovascular disease and reduction in blood cholesterol.

Which conditions are treated with Praluent and Repatha?

The Food and Drug Administration (FDA) has approved Repatha and Praluent to treat the following:

Both Repatha and Praluent are approved to:

  • Treat adults with primary hyperlipidemia (high cholesterol), including those with heterozygous familial hypercholesterolemia (HeFH). Both drugs are used alongside a healthy diet and may be used with other LDL-lowering treatments.
  • Reduce the risk of cardiovascular problems (such as heart attack and stroke) in adults.

Repatha has an additional indication to treat adults and children aged 13 to 17 years with homozygous familial hypercholesterolemia (HoFH). Repatha is used together with a healthy diet and other LDL-lowering treatments.

When are Praluent and Repatha prescribed?

The American College of Cardiology and The American Heart Association (ACC/AHA) recommends that you and your doctor consider a PCSK9 inhibitor in the following situations:

  • You have familial hypercholesterolemia (a genetic condition) which involves extremely high cholesterol levels
  • You are classed as high risk for a cardiovascular problem and your cholesterol is not controlled with statins or other cholesterol-lowering drugs

In both these situations above, statins are prescribed first to lower your cholesterol levels. If further help is needed to reduce levels, a drug such as Zetia (ezetimibe) is prescribed. Another alternative may be bile acid resins drugs such as Welchol (colesevelam), or Colestid (colestipol).
If the addition of this second type of drug does not lower your cholesterol levels to a safe level then a PCSK9 inhibitor would be suggested by your doctor.

How are Repatha and Praluent taken?

Repatha and Praluent both come in liquid form that is given as a subcutaneous injection meaning it is injected under the skin. Both come as prefilled syringes.

Repatha can also be used as a SureClick autoinjector and as the Pushtronex system, which is a single-use, on-body infusor with prefilled cartridges.

Praluent also comes as a prefilled pen.

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What are the common side effects of Praluent and Repatha?

Repatha and Praluent have some similar side effects and others that are different. Below are examples of these side effects.

Repatha side effects only:

  • High blood sugar
  • Urinary tract infection (UTI)
  • Painful back

Side effects that can occur with both Repatha and Praluent:

  • Irritation at the injection site
  • Influenza (flu)
  • The common cold

A serious side effect that can occur with both Repatha and Praluent when taken individually is an allergic reaction.

How effective are Praluent and Repatha?

These drugs haven’t been directly compared in clinical trials. However, studies have found both Repatha and Praluent to be effective for treating high cholesterol.

Lipid-lowering therapies are used to reduce the risk of heart attack, stroke, and unstable angina that requires a hospital stay in adults with heart disease. Your treatment options should be discussed with your healthcare provider who will give you individual medical advice to help you make the right choice.

Do Praluent and Repatha make you gain weight?

Weight gain was not reported as a side effect in the studies on Praluent or Repatha.

Are Praluent and Repatha statins?

No. Praluent and Repatha are not statins. They work entirely differently from statins. These drugs are classed as PCSK9 inhibitors. They block the action of an enzyme known as PCSK9 causing the levels of LDL in the blood to reduce.

Is it safe to take Praluent or Repatha when you are pregnant?

Praluent and Repatha have not been studied during pregnancy. Therefore it is not known if it is safe to do so. As always please seek medical advice to discuss the risks and benefits of using these drugs in pregnancy.

Is it safe to take Praluent or Repatha while breastfeeding?

Praluent and Repatha have not been studied in breastfeeding women. Therefore it is not known if it is safe to do so. Please seek medical advice to discuss the risks and benefits of using these drugs if you are breastfeeding or are planning to do so.

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.
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