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Alirocumab (Praluent) — PCSK9-inhibitor monoclonal antibody
A fully human monoclonal-antibody PCSK9 inhibitor (Praluent), injected under the skin every 2 weeks, that lowers LDL cholesterol by ~50–60%. In the ODYSSEY OUTCOMES trial of ~18,900 post-heart-attack patients it reduced major cardiovascular events and showed a possible all-cause mortality signal. Generally well tolerated; injection-site reactions and high cost/access are the main trade-offs. Prescription drug, not a supplement.
Prescription medication — not a dietary supplement
Alirocumab (Praluent) is a prescription (or investigational) drug, not a supplement. It is included here for reference because people research and discuss it (often used off-label) — not as a recommendation. Take it only under a qualified clinician's supervision and only as prescribed; do not source it from grey-market vendors, where identity, purity, and dosing are unverified. The evidence below reflects its clinical trials.
What the evidence says
Most Alirocumab (Praluent) studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from high-quality meta-analyses and randomised trials published 2012–2026.
Based on 213 studies · 62 meta-analyses · 129 RCTs
Confidence
High confidenceBy outcome
Alirocumab has strong randomized human-outcome evidence: ODYSSEY OUTCOMES (~18,900 post-ACS patients) showed reduced major cardiovascular events and a possible all-cause mortality signal, on top of consistent ~50–60% LDL-C lowering across LONG TERM and familial-hypercholesterolemia trials and supporting meta-analyses. The score reflects genuinely strong cardiovascular evidence balanced against practical trade-offs — a subcutaneous injection with injection-site reactions, and high cost/access barriers — for a prescription drug presented as informational, not a recommendation.
231 rigorous studies
137 randomized trials · 70 meta-analyses · 67 systematic reviews
Our evidence rating for Alirocumab (Praluent) is accountable to this entire body of rigorous research indexed in PubMed — not a hand-picked subset.
PubMed · as of Jul 2026
26 trials ongoing or recruiting · 68 completed on ClinicalTrials.gov
38 of the completed trials have posted results
Registered trials show research momentum for Alirocumab (Praluent), not proof of effect — a registration is a plan, and posted results are sponsor-reported, not peer-reviewed. They are never counted toward the evidence rating above.
Browse these trials on ClinicalTrials.govClinicalTrials.gov · as of Aug 2026
Alirocumab is a fully human monoclonal antibody that inhibits PCSK9 (proprotein convertase subtilisin/kexin type 9).
PCSK9 normally binds the LDL receptor on liver cells and marks it for degradation; by blocking PCSK9, alirocumab spares LDL receptors so they keep recycling to the cell surface and clearing LDL cholesterol from the blood.
The result is a large LDL-C reduction — roughly 50–60% on top of statin therapy — that is mechanistically distinct from statins (which raise receptor expression) and additive to them. It is given as a subcutaneous injection, typically 75 mg or 150 mg every two weeks (a monthly 300 mg option also exists).
The landmark human-outcome evidence is ODYSSEY OUTCOMES (Schwartz 2018, NEJM): in ~18,900 patients with a recent acute coronary syndrome already on intensive statins, alirocumab significantly reduced major adverse cardiovascular events (death from coronary heart disease, non-fatal MI, ischemic stroke, or unstable-angina hospitalization), with a possible reduction in all-cause mortality — a signal that strengthened in higher-risk subgroups.
Supporting trials (ODYSSEY LONG TERM, ODYSSEY FH I/II) confirm the durable, large LDL-lowering across high-risk and familial-hypercholesterolemia populations, and an imaging trial (ODYSSEY J-IVUS) examined coronary atheroma.
Alirocumab is a sibling of evolocumab — the same PCSK9-inhibitor class with the same mechanism and broadly similar effects.
The honest trade-offs are practical rather than toxic: injection-site reactions are the most characteristic adverse event, the antibody must be injected (not a pill), and historically high cost plus prior-authorization hurdles have limited access.
Alirocumab is a prescription drug for lipid management — it is presented here as a gated, informational research entry, not a supplement and not a recommendation.
A fully human monoclonal antibody binds circulating PCSK9, preventing it from tagging LDL receptors for degradation.
With PCSK9 blocked, LDL receptors recycle back to the hepatocyte surface and keep clearing LDL-C from blood, lowering LDL ~50–60%.
Sustained, very low LDL-C reduces atherosclerotic plaque burden and major cardiovascular events in high-risk patients.
How Alirocumab (Praluent) works — from molecular targets to health outcomes. Click an edge to see supporting research.This visualization is in beta — pathways are being refined and expanded.
Avoid — limited human data; lipid-lowering therapy is generally paused during pregnancy.
Often a candidate group, but use is clinician-directed and access-dependent.
A studied indication (ODYSSEY FH I/II); manage under a lipid specialist.
Intended additive combination — alirocumab is designed to be layered on statins for further LDL-C lowering; not an adverse interaction.
Commonly combined; additive LDL-C lowering with no major safety interaction.
Tip: Local redness/itching/swelling; rotate sites and warm the pen to room temperature to reduce reactions.
Tip: Generally self-limited; reported at low rates above placebo in trials.
Tip: Discontinue and seek care for serious allergic reactions; rare in trials.
Alirocumab (Praluent) has an evidence score of 4.5/10 — emerging evidence based on 93 indexed studies, including 1 meta-analysis. A fully human monoclonal-antibody PCSK9 inhibitor (Praluent), injected under the skin every 2 weeks, that lowers LDL cholesterol by ~50–60%. In the ODYSSEY OUTCOMES trial of ~18,900 post-heart-attack patients it reduced major cardiovascular events and showed a possible all-cause mortality signal. Generally well tolerated; injection-site reactions and high cost/access are the main trade-offs. Prescription drug, not a supplement. Representative study: PMID 39304616.
The commonly studied dose of Alirocumab (Praluent) is Prescription dosing is 75 mg or 150 mg subcutaneously every 2 weeks (a 300 mg every-4-weeks option exists), titrated by a clinician to the LDL-C target. A prescription drug; not a self-administered supplement regimen.. Individual needs vary — start at the lower end of the range and adjust based on how you respond.
Timing is flexible for Alirocumab (Praluent) — consistent daily use matters more than the time of day. A subcutaneous injection whose absorption is independent of meals; rotate injection sites (abdomen, thigh, upper arm) to limit local reactions.
Alirocumab (Praluent) should be used with caution — talk to a healthcare provider before taking it. The most commonly reported side effects are injection-site reaction, nasopharyngitis / flu-like symptoms, hypersensitivity / allergic reaction. Use caution if any of these apply to you: Known serious hypersensitivity to alirocumab or excipients; Pregnancy (limited data; lipid lowering generally deferred in pregnancy).
Pioglitazone (Actos)
Mostly mechanism / observationalAn oral thiazolidinedione (Actos) diabetes drug that improves insulin sensitivity via PPAR-gamma. It drew geroscience interest after reducing recurrent stroke/MI in insulin-resistant non-diabetics (IRIS) and improving NASH liver histology — but weight gain, fluid retention / heart-failure risk, fracture risk, and a debated bladder-cancer signal keep enthusiasm in check. Prescription drug, not a supplement.
CoQ10
Likely helpsA lipid-soluble antioxidant central to mitochondrial energy production, with the strongest trial support for fertility/IVF outcomes and heart failure.
Red Yeast Rice
Likely helpsFermented rice containing natural statins that effectively lower LDL cholesterol — the original statin.
Berberine
Likely helpsActivates AMPK to regulate blood sugar, improve insulin sensitivity, and support lipid metabolism — comparable to metformin in some trials.
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Reviewed by Dr. Baher Al Hakim · Last reviewed June 2026 · evidence from 213 studies · how we score · editorial policy
This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication.
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