Both medications are typically given as a subcutaneous (under the skin) injection every two or four weeks.
Moreover, some side effects are different.
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What Is Praluent?
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In HoFH, the FDA only approved Praluent for use in combination with other LDL-lowering medications.
Some examples of other LDL-lowering medications may includestatinsand Zetia (ezetimibe).
So, PCSK9 inhibitors (like Praluent) are not the initial go-to options for most people.
Experts typically recommend a statin first.
Afterward, if necessary, ezetimibe is the next add-on choice.
What Is Repatha?
Repatha is a monoclonal antibody called evolocumab, which is also considered the active ingredient.
It works by inhibiting the proprotein convertase subtilisin kexin pop in 9 (PCSK9) protein.
So, Repatha is in the PCSK9 inhibitor drug class.
In children with HeFH, Repatha is taken with a healthy diet and other LDL-lowering medications.
As for children with HoFH, the FDA only approved Repatha for use in combination with other LDL-lowering medications.
Since it is also a PCKS9 inhibitor, Repatha works the same way that Praluent works.
The following, however, are some general dosing guidelines.
Praluent:
Praluent comes in a 75 mg or 150 mg prefilled pen.
So, for 300 mg doses, you will need to use two 150 mg prefilled pens.
Side Effects and Precautions
The following table lists some common side effects of Praluent vs Repatha.
Note that the needle cover of the Repatha prefilled syringe and autoinjector also contain latex.
Get medical help immediately if you develop a severe allergic reaction or serious side effects.
Call 911 if your symptoms feel life-threatening.
The long-term safety of both PCSK9 inhibitors is currently unknown.
To inject the medicine under your skin, you push a button on the equipment.
A prefilled syringe is a single-use syringe already “prefilled” with a specific Repatha dose of 140 mg.
The prefilled SureClick autoinjector is a single-use gadget already filled with 140 mg of Repatha.
The Pushtronex system is also a unit with an injection button, but it looks different.
For more detailed instructions, reach out to a healthcare provider.
Potential for Interaction
There is limited information about drug interactions for PCSK9 inhibitors.
Which Is Better?
Though Repatha had a positive impact on heart attacks, there were no noted effects for Praluent.
So, the meta-analysis suggested that Praluent might be less effective than Repatha.
On the other hand, expert guidelines do not favor one PCSK9 inhibitor over the other.
These guidelines also didn’t mention using both PCSK9 inhibitors together.
Summary
The PCSK9 inhibitor drug class includes Praluent and Repatha.
The FDA approved these PCSK9 inhibitors to reduce LDL in certain people.
In people with heart disease, both PCSK9 inhibitors lower the risk of heart attack and stroke.
However, Praluent also decreases the risk of unstable angina that requires hospitalization.
Repatha, on the other hand, reduces the risk of coronary revascularization.
Additionally, Repatha has more dosage form options than Praluent.
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