Repatha (evolocumab) and Praluent (alirocumab) are brand-name prescription medications. They’re approved by the Food and Drug Administration (FDA) to reduce specific cardiovascular risks and treat certain types of high cholesterol in some people.
This article describes the key differences and similarities between Repatha and Praluent. If you’re considering one of these drugs, talk with your doctor. Reviewing this information with them can help you decide whether Repatha or Praluent may be right for you.
Note: For more comprehensive information about these two drugs, you can refer to our Repatha and Praluent articles.
Key differences between Repatha and Praluent
These are a few of the main differences between Repatha and Praluent:
- Forms: Both Repatha and Praluent are liquid solutions given as subcutaneous injections. But Repatha is available in several forms, while Praluent comes only as a prefilled pen. (See “Dosages, forms, and administration” below.)
- Uses: Repatha and Praluent are both used to reduce the risk of heart attack and stroke and treat high cholesterol. However, the two drugs are also each used to reduce other specific risks. (See “Uses of Repatha vs. Praluent” below.)
How much Repatha or Praluent costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy. You can visit Optum Perks for price estimates of Repatha and Praluent.
Both Repatha and Praluent are brand-name drugs. Neither medication is available in a biosimilar form. Brand-name medications are often more expensive than biosimilars. For details about biosimilars, see the “Generics or biosimilars: Repatha or Praluent” below. You can also talk with your doctor or pharmacist.
Repatha and Praluent both belong to a class of drugs called PCSK9 inhibitors. These drugs can cause some of the same side effects, as well as some different ones. Some of the side effects reported in clinical trials of these drugs are mentioned below.
For more details about side effects of the two drugs, see our articles about Repatha and Praluent. You can also refer to the prescribing information for Repatha and Praluent.
Mild side effects
The following table lists some of the more commonly reported mild side effects of Repatha and Praluent. The table may also include mild side effects that are less common but that you might have concerns about in some cases.
| Mild side effects | Repatha | Praluent |
| dizziness | ✓ | |
| fatigue | ✓ | |
| headache | ✓ | |
| nausea or inflammation of the stomach and intestines | ✓ | |
| diarrhea | ✓ | ✓ |
| back pain | ✓ | |
| muscle or joint pain | ✓ | ✓ |
| nasopharyngitis (inflammation of the nasal passages and throat) | ✓ | ✓ |
| mild infection, such as urinary tract infection or the flu | ✓ | ✓ |
| injection site reactions, such as pain, bruising, warmth, or discoloration around the injection site | ✓ | ✓ |
| mild allergic reaction | ✓ | ✓ |
These side effects may be temporary, lasting a few days to weeks. If the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Serious side effects
The following table lists the reported serious side effects of Repatha and Praluent.
| Serious side effects | Repatha | Praluent |
| high blood pressure | ✓ | |
| high blood sugar, which may lead to diabetes | ✓ | |
| increased levels of liver enzymes (a type of protein), which could be a sign of liver damage | ✓ | |
| severe allergic reaction | ✓ | ✓ |
If you have serious side effects while using Repatha or Praluent, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.
Keep reading to learn about the effectiveness of Repatha and Praluent.
Review of studies. Separate studies of Repatha and Praluent have been compared in several larger reviews of studies. One review found that both drugs were effective in reducing specific cardiovascular risks. In addition, this review found that Repatha and Praluent were effective in treating high cholesterol.
Keep in mind that these results may not apply to your individual health situations. Your doctor can advise you on whether Repatha or Praluent may be right for you.
Prescribing information. For information about how these drugs performed in clinical trials, see the prescribing information for Repatha and Praluent. It’s important to note that trial results may not apply to your individual health situation.
Treatment guidelines. Another way to determine whether a drug is considered effective is to look at treatment guidelines. When an organization includes certain drugs in treatment guidelines, this means that research has shown the drug to be safe and effective.
Below are answers to some common questions about Repatha and Praluent.
Is Repatha a better treatment option than Praluent or vice versa?
It depends. Whether Repatha or Praluent is a better treatment option is based on several factors. These include your age and the condition you use the drug to help prevent or treat. Your doctor can help determine whether Repatha or Praluent is a better treatment option for you.
For details about the uses of both drugs, see “Uses of Repatha vs. Praluent” below. You can also refer to our articles about Repatha and Praluent.
Can I use Repatha and Praluent together?
No, your doctor isn’t likely to prescribe Repatha and Praluent together. This is because both medications belong to a drug class called PCSK9 inhibitors. Repatha and Praluent work in similar ways to treat your condition. Taking both medications together could increase your risk of side effects from either drug.
For details about the side effects of both drugs, see “Side effects of Repatha vs. Praluent” above. You can also view our articles about Repatha and Praluent.
Here’s a quick look at the dosage and administration of Repatha and Praluent for the conditions both drugs are used for. In the tables below, milligrams and milliliters are abbreviated as mg and mL.
Dosage for reducing specific cardiovascular risks
Below are the dosages of Repatha and Praluent for reducing specific risks in people with cardiovascular disease. Both drugs are used to lower the risks of heart attack and stroke.
| Repatha for reducing specific cardiovascular risks | Praluent for reducing specific cardiovascular risks | |
| Forms | solution given by subcutaneous injection in these forms: • prefilled autoinjector called Repatha SureClick • prefilled syringe • prefilled cartridge to be used with the Pushtronex system (an on-body infuser that injects the drug over about 5 minutes) | solution in prefilled pen, given by subcutaneous injection |
| Strengths | • 140 mg/mL in autoinjector and syringe • 420 mg/3.5 mL in cartridge | • 75 mg/mL • 150 mg/mL |
| Dose and frequency | either: • 140 mg once every 2 weeks • 420 mg once every month | either: • 75 mg once every 2 weeks • 300 mg once every month |
| Given by | self (see below) | self (see below) |
A healthcare professional will show you or your caregiver how to give Repatha or Praluent injections at home.
Dosage for high cholesterol (primary hyperlipidemia and HeFH)
Below are the dosages of Repatha and Praluent for treating high cholesterol caused by specific factors. These include inherited conditions such as primary hyperlipidemia and heterozygous familial hypercholesterolemia (HeFH).
| Repatha for primary hyperlipidemia and HeFH | Praluent for primary hyperlipidemia and HeFH | |
| Forms | solution given by subcutaneous injection in these forms: • prefilled autoinjector called Repatha SureClick • prefilled syringe • prefilled cartridge to be used with the Pushtronex system (an on-body infuser that injects the drug over about 5 minutes) | solution in prefilled pen, given by subcutaneous injection |
| Strengths | • 140 mg/mL in autoinjector and syringe • 420 mg/3.5 mL in cartridge | • 75 mg/mL • 150 mg/mL |
| Dose and frequency | either: • 140 mg once every 2 weeks • 420 mg once every month | either: • 75 mg or 150 mg once every 2 weeks • 300 mg once every month |
| Given by | self (see below) | self (see below) |
A healthcare professional will show you or your caregiver how to give Repatha or Praluent injections at home.
Dosage for high cholesterol (HoFH)
Below are the dosages of Repatha and Praluent for treating high cholesterol caused by an inherited condition called homozygous familial hypercholesterolemia (HoFH).
| Repatha for HoFH | Praluent for HoFH | |
| Forms | solution given by subcutaneous injection in these forms: • prefilled autoinjector called Repatha SureClick • prefilled syringe • prefilled cartridge to be used with the Pushtronex system (an on-body infuser that injects the drug over about 5 minutes) | solution in prefilled pen, given by subcutaneous injection |
| Strengths | • 140 mg/mL in autoinjector and syringe • 420 mg/3.5 mL in cartridge | • 75 mg/mL • 150 mg/mL |
| Dose and frequency | either: • 420 mg once every 2 weeks • 420 mg once every month | 150 mg once every 2 weeks |
| Given by | self (see below) | self (see below) |
A healthcare professional will show you or your caregiver how to give Repatha or Praluent injections at home.
Note: For more information about dosage, see our articles about Repatha and Praluent.
Here’s information about the generic and biosimilar status for Repatha and Praluent, as well as details about their active ingredients.
| Repatha | Praluent | |
| Generic available | no | no |
| Biosimilar available | no | no |
| Active ingredient | evolocumab | alirocumab |
| Drug class | PCSK9 inhibitor | PCSK9 inhibitor |
Repatha and Praluent are biologic drugs. This means they’re made from parts of living cells. Biologics are different from traditional drugs, which are made from chemicals.
The active drug in traditional brand-name drugs can be copied exactly. These copies are made available as generics. However, biologics cannot be copied exactly. So, these drugs have biosimilars instead of generics.
The Food and Drug Administration (FDA) has approved Repatha and Praluent for the following uses:
Both Repatha and Praluent are FDA-approved to:
- Help reduce specific risks, including heart attack and stroke, in adults with cardiovascular disease (CVD).
- Treat high cholesterol in certain adults caused by different factors. These include inherited conditions such as:
- primary hyperlipidemia (“primary” means inherited from your parents)
For this purpose, Repatha and Praluent may be used alone or in combination with a low-cholesterol diet or other cholesterol-lowering treatments.
Repatha is also FDA-approved to:
- Help reduce the need for certain heart surgeries in adults with CVD.
Praluent is also FDA-approved to:
- Help reduce the risk of unstable angina (a type of chest pain) in adults with CVD.
Repatha or Praluent and children
Repatha has been approved by the FDA for the following uses in children.
Repatha is FDA-approved to:
- Treat high cholesterol in children ages 10 years and older with HeFH. For this purpose, Repatha is used in combination with a low-cholesterol diet and other cholesterol-lowering treatments.
- Treat high cholesterol in children ages 10 years and older with HoFH. For this purpose, Repatha is used in combination with other cholesterol-lowering treatments.
Praluent is not currently FDA-approved for children.
Note: For more information about the drugs’ uses, see our articles about Repatha and Praluent.
Repatha and Praluent may not be right for you if you have certain medical conditions or other factors that affect your health. The two drugs share some of the same precautions, but they also have different ones. Some of these precautions are mentioned below.
If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Repatha or Praluent.
| Precaution | Repatha | Praluent |
| if you’re allergic to latex or rubber | ✓ | |
| if you’ve had an allergic reaction to either drug or any of its ingredients | ✓ | ✓ |
| if you’re pregnant or thinking about becoming pregnant | ✓ | ✓ |
| if you’re breastfeeding or thinking about breastfeeding | ✓ | ✓ |
Note: For more comprehensive information about these two drugs, you can refer to our Repatha and Praluent articles.
Switching between Repatha and Praluent might be possible.
If you’d like to know more about switching between Repatha and Praluent, talk with your doctor. They can give you additional details and help determine the best course of action for your personal situation. Even if two drugs treat the same condition or are in the same drug class, your body can still respond differently.
It’s important that you do not stop, start, or switch any of your drug treatments without your doctor’s recommendation.
Some key points to remember when comparing Repatha and Praluent include:
- Both Repatha and Praluent are used to decrease the risk of stroke and heart attack. The medications are also used to treat high cholesterol. In addition, Repatha and Praluent are used to reduce other specific cardiovascular risks.
- Repatha and Praluent come as liquid solutions and are given as subcutaneous injections. Repatha is available in three forms, but Praluent comes just as a prefilled pen.
If you’d like to learn more about Repatha or Praluent, talk with your doctor or pharmacist. They can help answer any questions you have about similarities and differences between the drugs. They can also help determine whether one drug or the other might work well for you.
Note: For more information about decreasing the risk of certain cardiovascular problems and lowering cholesterol, see our cardiovascular hub and cholesterol hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.