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PCSK9 inhibitors are a form of injectable proteins that are created inside the laboratory, and area meant to lower your LDL cholesterol levels.

High cholesterol is usually treatable by making the required dietary changes and by integrating physical activities as a consistent and frequent part of your life. However, there are cases when lifestyle changes aren’t enough, or when cholesterol levels are so elevated, doctors have to turn to medication to improve the situation faster.

There are different types of drugs prescribed to treat high cholesterol. Some work to lower LDL and triglyceride levels, while others help increase HDL cholesterol. PCSK9 inhibitors are a newer class of cholesterol-lowering drugs, but with very promising results.

How PCSK9 inhibitors work

PCSK9 inhibitors are a form of injectable proteins that are created inside the laboratory, and are meant to lower your LDL cholesterol levels. There are currently two types of PCSK9 inhibitors approved by the FDA: evolocumab and alirocumab.

PCSK9 inhibitors work by targeting other proteins in the liver. The cells inside the liver have a set of receptors that are meant to absorb the excess cholesterol found in your bloodstream. However, these proteins are destroyed by another protein, which is known as PCSK9.

This is where PCSK9 inhibitors come into play. The bind onto the proteins that destroy those of the liver receptacles, and prevent them from doing do. As this happens, the receptors are more capable of doing their job, which means lowering the amount of LDL cholesterol in the blood.

Research has revealed the fact that PCSK9 inhibitors can lower cholesterol levels by an average of 47 percent, which also leads to a 27 percent reduced risk of suffering a heart attack due to issues related to high cholesterol levels.

At this point, the FDA has only approved PCSK9 inhibitors treatment for patients that have familial hypercholesterolemia, or for those who are at great risk of heart attack or stroke.

PCSK9 inhibitors are given to patients in the form of shots, which are administered once every two or four weeks. The pain of the shot is mild, and doctors will teach you how to inject the treatment yourself. These injections are typically administered in the upper thigh, the stomach, or the upper arm.

PCSK9 inhibitors and other cholesterol drugs

Probably the first drug that comes to mind for the treatment of high cholesterol is statin. Statins are a class of drugs that blocks the enzyme your liver uses for cholesterol production, thus effectively lowering your LDL cholesterol level.

While statins are available exclusive in a pill form, PCSK9 inhibitors are injectable proteins. These two classes of treatments can be used together for maximum efficiency, as is capable of lowering your LDL levels by more than 50 percent.

PCSK9 inhibitors side effects

As with every other drug on the market, PCSK9 inhibitors may come with a series of side effects, depending on how your body responds to the treatment. Since this is an injectable drug, you may experience swelling or skin redness in that specific area.

Other side effects of taking these inhibitors are back pain, allergic reactions, or muscle pain. In clinical trials, about 69 percent of the participants reported feeling some sort of side effects after administering the PCSK9 inhibitor known as evolocumab.

Since this treatment is relatively new, the long term side effects of PCSK9 inhibitors have yet to be studied.

Are PCSK9 inhibitors for you?

PCSK9 inhibitors are typically prescribed in more extraordinary situations, and aren’t the first choice on the doctor’s list. If lifestyle changes fail or if your cholesterol levels are simply too high to wait until the dietary changes show significant results, only then will doctors turn to medication as a form of treating cholesterol levels.

In general, doctors will only prescribe PCSK9 inhibitors treatment to patients who have already tried a statin-based treatment, but without the expected results. Before such a prescription, doctors can order different other tests to assess your current risk of developing heart disease. If your risks are high, then the doctor might choose a PCSK9 inhibitor treatment, such as evolocumab, since this drug has been successful in preventing strokes and heart attacks.

A very important thing to keep in mind at this point is that PCSK9 inhibitors are very expensive. Because of that, doctors are very likely to prescribe statins at first. However, statins are not always efficient in every high cholesterol scenario.

That being said, talk to your doctor about a potential PCSK9 inhibitors treatment if you fall under one of these three categories:

  • If you’ve followed a statin based treatment, but your body doesn't respond well to it and your cholesterol level aren’t dropping, talk to your doctor about PCSK9 inhibitors. Out of all the patients who take a statin treatment, about 10 to 20 percent have chances of developing side effects, and might have to give them up.
  • If you are at risk of having a stroke or a heart attack, you might also want to explore your options in terms of a PCSK9 inhibitors treatment.
  • If you have a condition known as familial hypercholesterolemia, then you gene mutation naturally causes your body to have high cholesterol levels. This also prevents your body from processing cholesterol with the efficiency of a body that doesn’t have this mutated gene. A statins treatment doesn’t always bring the cholesterol of someone with familial hypercholesterolemia to a healthy level, so PCSK9 inhibitors might be a more suitable option.

As we mentioned earlier, the price of PCSK9 inhibitors is really expensive, and shots for an entire year can cost as much as $14,000. You may expect to pay less depending on your health insurance, so talking to your doctor is the easiest path to exploring your options.


PCSK9 inhibitors are an injectable protein, a new type of cholesterol-lowering treatment that’s proven to be very efficient in reducing the risk of heart disease and stroke. While effective, PCSK9 inhibitors are also very expensive, so they are often considered a “last resort” by doctors who are looking for ways to improve a person’s cholesterol levels.

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