Formulary
Alirocumab: Indications, Dosing, Side Effects and Interactions
Alirocumab binds to a pro-protein involved in the regulation of LDL receptors on liver cells; receptor numbers are increased, which results in increased...
MedNext Academy | 3 min read
Alirocumab: Indications, Dosing, Side Effects and Interactions
Alirocumab binds to a pro-protein involved in the regulation of LDL receptors on liver cells; receptor numbers are increased, which results in increased...
Drug action
Alirocumab binds to a pro-protein involved in the regulation of LDL receptors on liver cells; receptor numbers are increased, which results in increased uptake of LDL-cholesterol from the blood.
Indications and dose
**Primary hypercholesterolaemia or mixed dyslipidaemia in patients who have not responded adequately to other appropriate measures [in combination with a statin, or with a statin and other lipid-lowering therapies, or with other lipid-lowering therapies or alone if a statin contra-indicated or not tolerated],Established atherosclerotic cardiovascular disease [in combination with the maximum tolerated dose of a statin with or without other lipid-lowering therapies, or with other lipid-lowering therapies or alone if a statin contra-indicated or not tolerated]**
- **Adult** (By Subcutaneous Injection): Initially 75 mg every 2 weeks; increased if necessary to 150 mg every 2 weeks, alternatively 300 mg every 4 weeks, patients requiring an LDL-C reduction of greater than 60% may be initiated on 150 mg every 2 weeks or 300 mg every 4 weeks, dose adjustments should be made at 4 to 8 weekly intervals.
Side effects
Common or very common Nasal complaints; oropharyngeal pain; pulmonary reaction; skin reactions Rare or very rare Hypersensitivity; hypersensitivity vasculitis Frequency not known Angioedema; influenza like illness
Interactions
**Other interactions (5):**
- Effects of alirocumab on other medicinal products Since alirocumab is a biological medicinal product, no pharmacokinetic effects of alirocumab on other medicinal products and no effect on cytochrome...
- Effects of other medicinal products on alirocumab Statins and other lipidmodifying therapy are known to increase production of PCSK9, the protein targeted by alirocumab.
- This leads to the increased target-mediated clearance and reduced systemic exposure of alirocumab.
- Compared to alirocumab monotherapy, the exposure to alirocumab is about 40%, 15%, and 35% lower when used concomitantly with statins, ezetimibe, and fenofibrate, respectively.
- However, reduction of LDL-C is maintained during the dosing interval when alirocumab is administered every two weeks.
Pregnancy
Manufacturer advises avoid unless clinical condition requires treatment-maternal toxicity in animal studies.
Breast feeding
Manufacturer advises avoid-no information available.
Hepatic impairment
Manufacturer advises use with caution in severe impairment-no information available.
Renal impairment
Manufacturer advises use with caution in severe impairment-limited information available.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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