Comprehensive medication guide to Praluent including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$35–$50 per month for commercially insured patients using the MyPRALUENT Copay Card; varies by plan tier and deductible; prior authorization required by virtually all plans.
Estimated Cash Pricing
$533–$777 per month for two prefilled pens (75 mg or 150 mg) at retail without discounts; as low as $225 with a GoodRx coupon for a biweekly supply.
Medfinder Findability Score
68/100
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Praluent (alirocumab) is a prescription injectable biologic medication used to lower LDL ("bad") cholesterol and reduce the risk of major cardiovascular events including heart attack and stroke. It belongs to a class of drugs called PCSK9 inhibitors — the most powerful LDL-lowering medications currently available, capable of reducing LDL-C by up to 63% on top of statin therapy.
Praluent was the first PCSK9 inhibitor to receive FDA approval, cleared on July 24, 2015. It is manufactured by Regeneron Pharmaceuticals and Sanofi. As of 2026, Praluent remains available only as a brand-name biologic — no generic or biosimilar version has been approved in the United States.
Praluent is FDA-approved to reduce the risk of heart attack, stroke, and unstable angina in adults with established cardiovascular disease, and to lower LDL-C in adults and children (aged 8+) with primary hyperlipidemia including heterozygous familial hypercholesterolemia (HeFH) and in adults with homozygous familial hypercholesterolemia (HoFH).
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Praluent is a human monoclonal antibody that binds to and inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9) — an enzyme produced by the liver that normally destroys LDL receptors on liver cell surfaces. By blocking PCSK9, Praluent prevents this receptor destruction, allowing more LDL receptors to be recycled back to the liver surface where they can capture and remove LDL cholesterol from the bloodstream.
Following a single subcutaneous injection, maximal suppression of free PCSK9 occurs within 4 to 8 hours. The result is a dramatic increase in LDL receptor activity and a corresponding reduction in circulating LDL-C of 45–63% from baseline when combined with statin therapy. The ODYSSEY OUTCOMES trial demonstrated that this LDL reduction translates to a 15% reduction in major adverse cardiovascular events versus placebo.
Unlike statins — which reduce cholesterol synthesis — Praluent increases cholesterol clearance. The two mechanisms are complementary, which is why Praluent is typically prescribed in combination with maximally tolerated statin therapy for patients who remain at high cardiovascular risk. As a protein-based biologic, Praluent is degraded to amino acids rather than processed by liver CYP450 enzymes, resulting in very few drug-drug interactions.
75 mg/mL — Prefilled autoinjector pen
Starting dose for adults; 75 mg every 2 weeks subcutaneously
150 mg/mL — Prefilled autoinjector pen
Maintenance dose; 150 mg every 2 weeks, or 300 mg (two injections) every 4 weeks
300 mg (monthly) — Two 150 mg/mL prefilled pens
Monthly dosing option; give two consecutive 150 mg injections at two different sites
Praluent is not on the FDA drug shortage list and Regeneron/Sanofi have not reported manufacturing disruptions. However, access challenges are real and well-documented. Most retail pharmacies (CVS, Walgreens, Walmart) do not stock Praluent because it requires refrigeration at 36–46°F, costs $533–$777 per month, and has low individual pharmacy prescription volume. Praluent is primarily dispensed through specialty pharmacies designated by insurance plans.
Prior authorization is required by virtually all commercial and Medicare Part D plans. The PA process requires documentation of cardiovascular disease or familial hypercholesterolemia, maximally tolerated statin therapy, and LDL-C above plan thresholds. Only about 50% of commercial plan members have Praluent coverage; Medicaid covers nearly all enrollees. First-round PA denials are common, and the appeals process adds weeks of delay for many patients.
If you're struggling to locate Praluent at a pharmacy near you, medfinder calls pharmacies on your behalf to check which ones have Praluent in stock and can fill your prescription — saving you hours of phone calls.
Praluent is not a controlled substance and does not require any special DEA authorization. Any licensed prescriber with DEA registration can prescribe it. In practice, PCSK9 inhibitors like Praluent are most commonly initiated by cardiovascular specialists and then managed by a variety of providers:
Cardiologists and preventive cardiologists (most common prescribers for ASCVD indications)
Lipid specialists and lipidologists (especially for familial hypercholesterolemia)
Endocrinologists (frequently involved in HeFH and metabolic disorder management)
Primary care physicians (PCPs) with established cardiovascular patients
Nurse practitioners (NPs) and physician assistants (PAs) — full prescribing authority in most states
Telehealth prescribing of Praluent is possible for established patients with documented cardiovascular history and lab work. New patients without prior cardiovascular workup typically require an in-person evaluation before a PCSK9 inhibitor is initiated. Some telehealth platforms specializing in cardiovascular risk management can prescribe Praluent after a video visit with appropriate documentation.
No. Praluent (alirocumab) is not a controlled substance and has no DEA scheduling. It does not have abuse potential or dependency risk. Any licensed prescriber — including primary care physicians, nurse practitioners, and physician assistants — can prescribe Praluent without any special DEA authorization or registration beyond what is required for any prescription medication.
Because Praluent is not a controlled substance, there are no restrictions on 90-day supplies, no mandatory in-person prescription requirements, and prescriptions can be called in or sent electronically to specialty pharmacies. Some early insurance prior authorization criteria used to require specialist prescribers, but most plans have removed that requirement. There are no state-specific PDMP (prescription drug monitoring program) requirements for Praluent.
Praluent has a favorable safety profile with no boxed warning. The most common side effects (occurring in more than 5% of patients):
Injection site reactions (redness, pain, swelling, or itching at injection site)
Influenza and nasopharyngitis (cold and flu-like symptoms)
Myalgia (muscle pain — more common in cardiovascular disease patients)
Diarrhea
Severe allergic reactions: Angioedema (swelling of face, lips, tongue, or throat), hypersensitivity vasculitis, severe rash, difficulty breathing — stop Praluent immediately and seek emergency care
Praluent does not cause liver toxicity, significant drug-drug interactions, or the statin-type myopathy that limits statin use for some patients.
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Repatha (evolocumab)
The most direct alternative — another PCSK9 inhibitor monoclonal antibody with nearly identical mechanism and 50–65% LDL-C reduction. Self-injected every 2 weeks or monthly. Some insurance plans prefer Repatha over Praluent on formulary.
Leqvio (inclisiran)
A PCSK9 siRNA therapy given in-office just twice per year (after loading doses), achieving ~50% LDL-C reduction. Covered under Medicare Part B for in-office administration, which can be advantageous for Medicare patients.
Nexletol (bempedoic acid)
An oral, once-daily non-statin option reducing LDL-C by 15–25%. CLEAR Outcomes trial demonstrated cardiovascular event reduction. Good option for statin-intolerant patients who can't access injectable therapy.
Zetia (ezetimibe)
Generic available; oral, once-daily cholesterol absorption inhibitor reducing LDL-C by 18–25% added to statins. Inexpensive (~$15–$40/month), widely available, often required by insurers before PCSK9 inhibitor approval.
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Leqvio (inclisiran)
moderateNot for combined use — both target the PCSK9 pathway; combining two PCSK9-targeting therapies is redundant and not studied for safety.
Statins (atorvastatin, rosuvastatin)
minorSafe and commonly used together. No relevant changes in statin concentrations observed when combined with Praluent. Complementary mechanisms.
Pregnancy / Monoclonal antibodies
moderateUnknown risk in pregnancy. Alirocumab crosses the placental barrier (especially near term), as do all IgG monoclonal antibodies. Report pregnancy exposure to Regeneron at 1-844-734-6643.
Praluent (alirocumab) is one of the most effective cholesterol-lowering medications ever developed, reducing LDL-C by up to 63% and demonstrating a 15% reduction in major cardiovascular events in the ODYSSEY OUTCOMES trial. It's a critical therapy for patients with familial hypercholesterolemia or established ASCVD who cannot reach LDL-C goals on maximally tolerated statin therapy alone.
The primary challenges with Praluent are not clinical — they're logistical and financial. Prior authorization hurdles, specialty pharmacy distribution, and a list price of $5,850/year create real barriers. But with the MyPRALUENT Copay Card (commercially insured: $35–$50/month), the MyPraluent Patient Assistance Program (eligible uninsured patients: no cost), and GoodRx coupons (as low as $225 per two-pen fill), most patients can find a path to affordability.
If you've been prescribed Praluent and need help finding it at a pharmacy near you, medfinder calls pharmacies on your behalf to locate which ones have your medication in stock — so you can spend your time getting better, not calling pharmacies.
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