Top Takeaways
- Lerodalcibep is a new once-monthly injectable PCSK9 inhibitor to help lower cholesterol.
- Keep lerodalcibep in the fridge if your pharmacy stocks it.
- Send patients for counseling on self-injection instructions.
Rx lerodalcibep (Lerochol) will be a new injectable med to lower high cholesterol.
It joins alirocumab (Praluent), evolocumab (Repatha), and inclisiran (Leqvio) as the fourth PCSK9 inhibitor.
These meds work a little differently to impact PCSK9 (a protein in the liver)...but ultimately, they help clear LDL cholesterol (LDL-C) or bad cholesterol from the blood.
Use this table to see how the PCSK9 inhibitors stack up.
|
Comparison of PCSK9 Inhibitors |
|||
|
Drug |
↓ LDL-C |
~Cost/year |
Considerations |
|
Alirocumab (Praluent) |
~ 60% |
$6,400 |
|
|
Evolocumab (Repatha) |
~ 60% |
$7,000 |
|
|
Inclisiran (Leqvio) |
~ 50% |
$7,400 + other costs (admin, etc) |
|
|
Lerodalcibep (Lerochol) |
~ 60% |
$5,400 |
|
Don’t expect to see a lot of Rxs for lerodalcibep yet.
Most patients will continue to start with statins...and get oral ezetimibe (Zetia) if another med is needed for additional LDL-C lowering.
Watch for alirocumab or evolocumab to be added to a statin plus ezetimibe...if a PCSK9 inhibitor is needed. These have more evidence for preventing cardiovascular events than lerodalcibep and inclisiran.
Anticipate prior auths with PCSK9 inhibitors...they’re costly.
Update patient profiles with these meds...even if they’re filled at a different pharmacy. This can help your pharmacist screen for problems.
If your pharmacy carries lerodalcibep, store it in its original packaging in the fridge. Tell patients to do the same...or they can keep it at room temp for up to 3 months if needed.
Ensure patients get pharmacist counseling on PCSK9 inhibitors. For instance, patients should remove lerodalcibep from the fridge at least 30 minutes before use...to limit injection site pain and discomfort.
Plus, it should be injected subcutaneously into the abdomen, thigh, or upper arm.
The first oral PCSK9 inhibitor, enlicitide, is on the horizon.
See our chart, Non-Statin Lipid-Lowering Agents, for a quick reference on dosing, lipid effects, and more.
- Klug EQ, Llerena S, Burgess LJ, et al. Efficacy and Safety of Lerodalcibep in Patients With or at High Risk of Cardiovascular Disease: A Randomized Clinical Trial. JAMA Cardiol. 2024 Sep 1;9(9):800-807.
- Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026 Apr 28;153(17):e1154-e1276.
- Marston NA, Bohula EA, Bhatia AK, et al. Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes: Results From the VESALIUS-CV Trial. JAMA. 2026 Apr 28;335(16):1400-1407.
- Medication pricing by Elsevier, accessed June 2026.