What is Inclisiran: Uses, Dosage, Side Effects and More

Inclisiran is a newer type of cholesterol-lowering medication that works differently from traditional statins. It's given as an injection under your skin twice a year by your healthcare provider, making it a convenient option for people who need extra help managing their cholesterol levels.

This medication belongs to a class called PCSK9 inhibitors, which block a protein that prevents your liver from removing bad cholesterol from your blood. Think of it as giving your liver a helping hand to do its cholesterol-cleaning job more effectively.

What is Inclisiran?

Inclisiran is a prescription medication designed to lower LDL cholesterol, often called "bad" cholesterol. It uses a technology called small interfering RNA (siRNA) to reduce cholesterol production in your liver.

Unlike daily pills, inclisiran is administered as a subcutaneous injection every six months after your initial doses. Your doctor or nurse will give you these injections in their office, usually in your upper arm, thigh, or abdomen.

The medication was approved by the FDA in 2021 and represents a significant advancement in cholesterol management. It's particularly helpful for people who haven't reached their cholesterol goals with other treatments or who have difficulty taking daily medications.

What is Inclisiran Used For?

Inclisiran is prescribed to adults with high cholesterol who need additional help beyond diet and exercise. It's specifically designed for people with atherosclerotic cardiovascular disease or familial hypercholesterolemia.

Your doctor might recommend inclisiran if you're already taking a statin but still have high LDL cholesterol levels. It can also be an option if you can't tolerate statins due to side effects like muscle pain or liver problems.

The medication is particularly valuable for people with familial hypercholesterolemia, a genetic condition that causes extremely high cholesterol levels from birth. These individuals often need multiple medications to manage their cholesterol effectively.

Inclisiran is always used alongside a healthy diet and lifestyle changes. It's not a replacement for eating well and staying active, but rather an additional tool to help you reach your cholesterol goals.

How Does Inclisiran Work?

Inclisiran works by targeting a specific protein called PCSK9 in your liver. This protein normally prevents your liver from removing LDL cholesterol from your bloodstream effectively.

The medication uses small interfering RNA technology to "silence" the gene that makes PCSK9 protein. When there's less PCSK9 around, your liver can remove more bad cholesterol from your blood, similar to removing the brakes from your liver's cholesterol-clearing system.

This approach is considered moderately strong compared to other cholesterol medications. While statins are still the first-line treatment, inclisiran can reduce LDL cholesterol by an additional 50% or more when added to existing therapy.

The effects last for several months after each injection because the medication continues working at the genetic level. This is why you only need injections twice a year rather than taking daily pills.

How Should I Take Inclisiran?

Inclisiran is given as an injection under your skin by a healthcare professional in a medical setting. You won't take this medication at home or by mouth.

The typical schedule starts with your first injection, followed by another injection three months later, then every six months after that. Your doctor will mark these dates on your calendar so you don't miss appointments.

You don't need to do anything special before your injection appointment. You can eat normally and take your other medications as usual. The injection itself takes just a few minutes and is similar to getting a vaccine.

After your injection, you can resume normal activities immediately. Some people experience mild soreness at the injection site, similar to what you might feel after any injection, but this typically goes away within a day or two.

How Long Should I Take Inclisiran For?

Inclisiran is typically a long-term treatment for managing chronic high cholesterol. Most people continue receiving injections for years, similar to how they might take daily cholesterol medications.

Your doctor will monitor your cholesterol levels and overall health regularly to determine if inclisiran continues to be right for you. They'll typically check your levels about 3-6 months after starting treatment and then periodically thereafter.

The decision to continue or stop inclisiran depends on how well it's working, whether you're experiencing side effects, and your overall cardiovascular risk. Some people may eventually transition to other treatments if their situation changes.

It's important to keep up with your scheduled injections even if you're feeling well. High cholesterol doesn't usually cause symptoms, so you might not feel different even though the medication is working to protect your heart and blood vessels.

What Are the Side Effects of Inclisiran?

Most people tolerate inclisiran well, but like all medications, it can cause side effects. The good news is that serious side effects are relatively uncommon.

Here are the most common side effects you might experience:

• Injection site reactions like redness, swelling, or pain
• Joint pain or muscle aches
• Fatigue or feeling more tired than usual
• Bronchitis or upper respiratory infections
• Dizziness or lightheadedness

These side effects are generally mild and tend to improve over time as your body adjusts to the medication. The injection site reactions usually resolve within a few days.

Less common but more serious side effects can include severe allergic reactions, though these are rare. Signs of a serious allergic reaction include difficulty breathing, swelling of your face or throat, or widespread rash.

Some people worry about liver problems, but inclisiran appears to be gentler on the liver than some other cholesterol medications. However, your doctor will still monitor your liver function with periodic blood tests.

If you experience any unusual symptoms after your injection, don't hesitate to contact your healthcare provider. They can help determine if what you're experiencing is related to the medication and how to manage it.

Who Should Not Take Inclisiran?

Inclisiran isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. The medication is not recommended for people under 18 years old, as its safety and effectiveness haven't been established in children.

You should avoid inclisiran if you've had a severe allergic reaction to it or any of its ingredients in the past. Your doctor will review the complete ingredient list with you if you have known allergies.

Women who are pregnant or breastfeeding should discuss the risks and benefits with their doctor. While there's limited data on inclisiran use during pregnancy, it's generally recommended to avoid it unless the benefits clearly outweigh the risks.

People with certain liver conditions may need special monitoring or might not be good candidates for inclisiran. Your doctor will evaluate your liver function before starting treatment and monitor it regularly.

If you have a history of severe kidney disease, your doctor will carefully consider whether inclisiran is appropriate for you. The medication hasn't been extensively studied in people with severe kidney problems.

Inclisiran Brand Names

Inclisiran is marketed under the brand name Leqvio in the United States and many other countries. This is currently the only brand name available for inclisiran.

Leqvio is manufactured by Novartis and is available as a pre-filled syringe for injection. The medication comes in a standard dose of 284 mg, which is the amount given in each injection.

Unlike some medications that have multiple brand names or generic versions, inclisiran is still relatively new and patent-protected. This means Leqvio is currently the only version available.

When discussing this medication with your doctor or pharmacist, you can refer to it as either inclisiran or Leqvio. They'll understand you're talking about the same medication.

Inclisiran Alternatives

If inclisiran isn't right for you, several other cholesterol-lowering options are available. Statins remain the first-line treatment and include medications like atorvastatin, rosuvastatin, and simvastatin.

Other PCSK9 inhibitors include evolocumab (Repatha) and alirocumab (Praluent). These work similarly to inclisiran but are given as injections every two weeks or monthly, rather than twice yearly.

For people who can't tolerate statins, alternatives include ezetimibe (Zetia), which blocks cholesterol absorption in your intestines, and bile acid sequestrants like cholestyramine.

Newer options include bempedoic acid (Nexletol), which works differently from statins but still reduces cholesterol production in the liver. Some people find this easier to tolerate than traditional statins.

Your doctor will help you choose the best option based on your specific situation, including your cholesterol levels, other health conditions, and how well you tolerate different medications.

Is Inclisiran Better Than Evolocumab?

Both inclisiran and evolocumab (Repatha) are PCSK9 inhibitors that effectively lower LDL cholesterol, but they have different advantages depending on your preferences and lifestyle.

The main advantage of inclisiran is convenience. You only need injections twice a year after the initial loading phase, compared to evolocumab's every-two-week or monthly injections. This can be much easier for people who dislike frequent injections or have busy schedules.

Evolocumab has been available longer and has more extensive clinical trial data, including studies showing it can reduce heart attacks and strokes. Inclisiran is newer, so while it effectively lowers cholesterol, we have less long-term data on cardiovascular outcomes.

Both medications are similarly effective at lowering LDL cholesterol, typically reducing levels by 50-60% when added to statin therapy. The choice between them often comes down to injection frequency preferences and individual response.

Cost and insurance coverage can also influence the decision. Your doctor can help you weigh these factors and determine which option makes the most sense for your specific situation.