alirocumab
Praluent (alirocumab) is a PCSK9 inhibitor from Sanofi and Regeneron. By blocking PCSK9, it preserves LDL receptors on liver cells, sharply lowering LDL cholesterol and reducing major cardiovascular events in adults at increased risk.
This page is based on FDA prescribing information and the EMA medicine record for alirocumab, cross-checked with the National Cancer Institute drug dictionary; the mechanism is explained in plain language, and analogies are used only where they stay accurate.
How it works
Explains what the medicine does in the body, not dosing, side effects, or safety.
An analogy
The liver clears LDL cholesterol with catcher's mitts, the LDL receptors. PCSK9 is a shredder that destroys mitts after each catch. Alirocumab ties up the shredder, so the mitts keep working round after round, pulling far more LDL out of the bloodstream.
In simple terms
LDL cholesterol is removed from the blood by receptors on liver cells. A protein called PCSK9 causes those receptors to be broken down, limiting how much cholesterol can be cleared. Alirocumab is an antibody that binds PCSK9 and stops it from working. More receptors survive on the liver surface, LDL levels fall sharply, and lower LDL translates into fewer heart attacks and strokes.
In depth
Alirocumab is a fully human IgG1 monoclonal antibody that binds PCSK9 with high affinity, preventing it from interacting with the epidermal growth factor-like repeat A domain of the hepatic LDL receptor. Without PCSK9-mediated degradation, LDL receptors recycle to the hepatocyte surface, increasing LDL uptake and lowering circulating LDL-C. In outcome trials, alirocumab reduced major adverse cardiovascular events in patients at high risk.
See it in motion
A schematic animation of the mechanism — simplified for clarity, not drawn to scale.
How alirocumab blocks PCSK9 and preserves LDL receptors
- LDL cholesterol is removed from the blood by receptors on liver cells. A protein called PCSK9 causes those receptors to be broken down, limiting how much cholesterol can be cleared.
- Alirocumab is a fully human IgG1 monoclonal antibody that binds PCSK9 with high affinity, preventing it from interacting with the epidermal growth factor-like repeat A domain of the hepatic LDL receptor.
- Without PCSK9-mediated degradation, LDL receptors recycle to the hepatocyte surface, increasing LDL uptake and lowering circulating LDL-C.
- In outcome trials, alirocumab reduced major adverse cardiovascular events in patients at high risk.
Target: PCSK9
A protein that binds LDL receptors on liver cells and targets them for destruction; when PCSK9 is blocked, more receptors remain on the cell surface to clear LDL cholesterol from the blood.
Approved uses
Approved uses differ by country and change over time. Always follow your local prescribing information.
Approved uses in United States
FDA- To reduce the risk of major adverse cardiovascular events (coronary heart disease death, myocardial infarction, stroke, or unstable angina requiring hospitalization) in adults at increased risk for these events
- As an adjunct to diet and exercise to reduce LDL cholesterol in adults with hypercholesterolemia
- As an adjunct to diet and exercise to reduce LDL cholesterol in adults and pediatric patients aged 8 years and older with heterozygous familial hypercholesterolemia
- As an adjunct to diet and exercise to reduce LDL cholesterol in adults with homozygous familial hypercholesterolemia
Approved uses in European Union
EMA- In adults with primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia, and in paediatric patients 8 years of age and older with heterozygous familial hypercholesterolaemia, as an adjunct to diet, in combination with a statin or with other lipid-lowering therapies in patients unable to reach LDL-C goals with the maximum tolerated statin dose, or alone or in combination with other lipid-lowering therapies in patients who are statin-intolerant or for whom a statin is contraindicated
- In adults with established atherosclerotic cardiovascular disease to reduce cardiovascular risk by lowering LDL-C levels, as an adjunct to correction of other risk factors
Official sources
The statements on this page trace back to these records.
- U.S. Food and Drug Administration: Praluent (alirocumab) prescribing information
U.S. Food and Drug Administration
- Praluent (alirocumab) — Summary of product characteristics and package leaflet, English version
European Medicines Agency
- National Cancer Institute: alirocumab
National Cancer Institute
This page explains how the medicine works — it isn’t the patient leaflet. For anything that applies to you, read the leaflet that came with your medicine or ask your pharmacist.
MedUnfold provides educational content and is not medical advice. Always follow your local prescribing information and healthcare professional.