Who Should Take Them?
Statins are the most common drug that lowers cholesterol. Doctors usually prescribe them first because they get the job done and most people can afford them.
But they don’t work for everyone. You may want to ask your doctor about PCSK9 inhibitors if:
You have genetic high cholesterol: About 600 thousand Americans have a genetic disorder called familial hypercholesterolemia. It affects how your body
processes cholesterol. For most people with this condition, even the highest dose of statins won’t bring their LDL cholesterol down to a healthy level.
You’re at risk for heart attack or stroke: If you already have heart disease and other medications, like statins, aren’t working, your doctor may consider
You can’t take statins: About 10% to 20% of people who do have side effects, like muscle pain, cramps, or weakness. They can also cause liver damage,
confusion, memory loss, or a rise in blood sugar.
Who Shouldn’t Take Them?
Most people with high cholesterol don’t need PCSK9 inhibitors. The FDA has only approved alirocumab and evolocumab for people with genetic high
cholesterol or serious heart disease including those who’ve already had a heart attack or stroke and who need their LDL cholesterol lower. If you don’t
have either of these conditions, your doctor will likely recommend another treatment.
When Will the Doctor Prescribe Them?
He’ll try different treatments before he gives you PCSK9 inhibitors. The first is usually lifestyle changes. He’ll tell you to eat right and get more exercise.
Both will help lower your cholesterol. You’ll likely need to see a dietitian for tips on how to improve your diet.
You may also need to take a statin. If your cholesterol doesn’t go down, your doctor will prescribe higher doses. If the maximum amount still doesn’t work
-- or if you can’t handle the side effects -- your doctor may consider a PCSK9 inhibitor. He also may order tests, like a coronary calcium score, to check your
heart disease risk. If you are diagnosed with heart disease, he may opt for prescribing evolocumab because of its effectiveness in preventing heart attacks and strokes.
You might take the PCSK9 inhibitor alone or paired with other cholesterol-lowering medications, like statins.
How Do You Take Them?
PCSK9 inhibitors are given as a shot every 2 or 4 weeks. You’ll need to inject the medicine in your upper arm, stomach, or upper thigh.
The doctor will teach you how to do it properly. The injection is usually easy with little pain. And you won’t have to remember to take a pill every day.
Are There Side Effects?
The most common side effects are mild. They include back pain and symptoms of a cold or the flu. Because it’s an injection, you may also have redness,
bruising, or pain around the area where you administer the shot. These drugs may also cause an allergic reaction in certain people. If you develop a severe
rash, swollen face, or trouble breathing, get emergency help right away.
How Much Do They Cost?
These drugs aren’t cheap. The price tag rings in at more than $14,000 per year. How much you’ll pay out of pocket depends on your health insurance.
You may be able to apply for a patient assistance program to offset the cost. Ask your doctor about your options.