A self-injection to lower cholesterol
Alirocumab
A self-injection used to lower harmful LDL cholesterol when statins are not enough or cannot be taken.
What is Alirocumab?
Alirocumab is a medicine used to lower LDL cholesterol, the harmful type linked to heart attacks and strokes. It belongs to a group called PCSK9 inhibitors, which help the liver clear more cholesterol from the blood. It is given as an injection under the skin, usually by the person themselves every couple of weeks after training. It is mainly for people whose cholesterol is not well controlled by statins, or who cannot take statins, and it is usually added to, not used instead of, other cholesterol treatment. The most common side effect is a reaction where the injection is given.
Education and reference only. This is a plain-language guide to Alirocumab — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Alirocumab is a PCSK9 inhibitor, a type of medicine that lowers LDL cholesterol, the harmful cholesterol that builds up in blood vessels and raises the risk of heart attacks and strokes. It is given as an injection under the skin, often by the person themselves at home after training, on a regular schedule. It is used for people whose cholesterol stays too high despite statins, or who cannot tolerate statins, usually alongside their other cholesterol treatment. It is a specialist-initiated medicine, prescribed when stronger cholesterol lowering is needed.
How it works
The liver removes LDL cholesterol from the blood using docking points called LDL receptors. A protein called PCSK9 breaks down these receptors, so the more PCSK9 there is, the fewer receptors remain and the more cholesterol stays in the blood. Alirocumab is an antibody that blocks PCSK9, so the liver keeps more of its receptors and clears more LDL cholesterol from the blood. This produces a substantial drop in LDL cholesterol. Because it works steadily, it is given on a regular schedule, and it is usually added to a statin or other treatment for a bigger combined effect.
Company & origin
Originated / developed by: Specialist manufacturer.
A self-injected medicine used in the UK to lower LDL cholesterol in people not controlled by statins or who cannot take them.
What it treats
Conditions Alirocumab is used for
Practical use
How to take Alirocumab
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Inject it under the skin on the regular schedule your team sets, using the technique you have been trained in.
- Keep taking your statin or other cholesterol treatment unless your team tells you otherwise, as alirocumab is usually an add-on.
- Rotate the injection site and let the medicine reach room temperature before injecting, if advised, to reduce discomfort.
- Store it as instructed, usually in the fridge, and protect it from light.
- Keep up your healthy diet, activity and other lifestyle measures, as these work alongside the medicine.
Weighing it up
Advantages & disadvantages of Alirocumab
Advantages
- Produces a large drop in harmful LDL cholesterol, on top of statins or when statins cannot be taken.
- Given as a self-injection at home every couple of weeks rather than daily.
- Generally well tolerated, without the muscle and liver monitoring needed for statins.
Disadvantages
- Commonly causes reactions where the injection is given, such as redness or soreness.
- Needs injecting and storing correctly, usually in the fridge.
- Usually reserved for people not controlled by statins or unable to take them, rather than first-line.
Practical use
Good to know
The main point is that alirocumab is usually an add-on for people who need more cholesterol lowering than statins alone can give, or who cannot take statins, rather than a first choice for everyone. It is a self-injection given under the skin every couple of weeks, so learning the technique and keeping to the schedule matters. The most common side effect is a reaction where the injection is given, such as redness, itching or soreness, which usually settles. It is generally well tolerated and does not need the same liver and muscle monitoring as statins, though your team still checks your cholesterol response. Keep up the lifestyle measures and any other cholesterol treatment you are on, as alirocumab works best as part of the whole plan. Store it as instructed, usually in the fridge.
Who should not take it / use with caution
- People who have had a serious allergic reaction to alirocumab should not use it.
- It is used in pregnancy only if a doctor judges it necessary, so tell your team if you are or may become pregnant.
- It should be started under specialist guidance, in line with the criteria for this type of medicine.
Monitoring
- Checking your cholesterol response to see how well it is working.
- Reviewing injection technique and whether you are managing the schedule.
- Watching for injection-site or allergic-type reactions.
Side effects
- Redness, itching, soreness or swelling where the injection is given.
- Cold-like symptoms or a mild reaction such as a stuffy or runny nose.
- Occasionally, muscle aches or flu-like feelings.
- Rarely, allergic-type reactions, which should be reported to your team.
Key interactions
- There are few well-established routine medicine interactions, as it is an injected antibody.
- It is usually combined with statins or other cholesterol treatments rather than replacing them.
- Tell your team about all your medicines so your overall cholesterol plan can be managed together.
Available as: A solution for injection under the skin, usually in a pre-filled pen or syringe, often given by the patient.
Answers
Alirocumab: frequently asked questions
What is alirocumab used for?
It is used to lower harmful LDL cholesterol in people whose cholesterol is not controlled by statins or who cannot take statins, helping reduce the risk of heart attacks and strokes.
How is it given?
It is given as an injection under the skin, usually by the person themselves at home every couple of weeks, after being trained in the technique.
Does it replace my statin?
Usually not. It is most often added to a statin or other cholesterol treatment for a bigger combined effect, unless you cannot take statins at all.
What is the most common side effect?
A reaction where the injection is given, such as redness, itching or soreness, is the most common side effect and usually settles on its own.
How should I store it?
It is usually kept in the fridge and protected from light; follow the storage instructions you are given and let it warm up before injecting if advised.
Authoritative sources
- BNF
- NICE CKS
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