Understanding Leqvio (Inclisiran) for High Cholesterol
Leqvio (inclisiran) is a prescription medication designed to assist in the treatment of specific forms of high cholesterol. Administered as an injection under the skin, Leqvio comes in a prefilled syringe.
Healthcare providers typically prescribe Leqvio to reduce low-density lipoprotein (LDL) cholesterol in adults diagnosed with hypercholesterolemia, including heterozygous familial hypercholesterolemia (HeFH). LDL is commonly referred to as “bad” cholesterol, and HeFH is an inherited condition where an individual inherits the gene for high cholesterol from one parent. Leqvio is prescribed as part of a comprehensive treatment plan that includes a balanced diet and regular exercise.
How Leqvio Works
Leqvio contains the active drug inclisiran. Its mechanism of action involves targeting the PCSK9 protein, which is produced by the liver and contributes to increased LDL cholesterol levels in the body. Leqvio works by decreasing the amount of PCSK9 the liver produces, thereby lowering LDL cholesterol levels.
It is important to note that while some cholesterol-lowering drugs have demonstrated a reduction in the risk of death and certain complications of high cholesterol, such as heart attack and stroke, it is not yet established whether Leqvio offers these same risk reductions. For this reason, healthcare providers may prescribe other cholesterol-lowering medications alongside Leqvio to help mitigate these risks.
Leqvio Dosage and Administration
Leqvio is administered as an injection under the skin by a healthcare professional in a clinical setting. It is available as a liquid in a prefilled syringe, with a strength of 284 milligrams (mg) in 1.5 milliliters (mL) of solution, with each syringe containing a single dose.
The recommended dosing schedule begins with an initial injection, followed by a second injection three months later. After these first two doses, subsequent injections are typically given once every six months. Injections may be given in the upper arm, thigh, or abdomen, avoiding areas with rashes, infections, inflammation, or sunburn.
If a dose is missed, it is crucial to contact the healthcare provider’s office immediately to reschedule. If the dose is received within three months of the missed appointment, the usual treatment schedule can continue. However, if more than three months have passed since the missed dose, the treatment schedule will need to be restarted with two doses three months apart. Leqvio is generally intended for long-term use if it proves safe and effective for the individual. Some individuals may experience lower cholesterol levels as early as two weeks after starting treatment.
Potential Side Effects of Leqvio
Like most medications, Leqvio can cause mild or serious side effects. The occurrence and severity of side effects can vary based on factors such as age, existing health conditions, and other medications being taken.
Mild Side Effects
Common mild side effects associated with Leqvio may include:
- Mild injection site reactions, such as pain, warmth, rash, or skin discoloration
- Joint pain
- Bronchitis (a type of lung infection)
Many mild side effects often resolve within a few days to a couple of weeks. If they become bothersome, it is advisable to consult a healthcare provider or pharmacist.
Serious Side Effects
Serious side effects from Leqvio are possible but uncommon. Clinical studies have indicated that severe injection site reactions are among the serious side effects. In the event of serious side effects, immediate medical attention is recommended.
Leqvio and Other Medications
Leqvio is not known to interact with other medications, herbs, supplements, foods, or alcohol. However, it is always important to inform your healthcare provider and pharmacist about all prescription, over-the-counter, and other drugs, as well as any vitamins, herbs, and supplements you are taking, before starting Leqvio treatment.
Leqvio is often prescribed in conjunction with a statin drug to further reduce cholesterol levels. Common statins include atorvastatin, rosuvastatin, and simvastatin. If statins are not suitable, a healthcare provider may prescribe Leqvio with another cholesterol-lowering drug, such as ezetimibe.
Leqvio is not a statin; statins are a distinct class of cholesterol-lowering drugs that operate through a different mechanism.
Leqvio vs. Repatha
Leqvio and evolocumab (Repatha) are both medications used to help lower cholesterol, though they work in slightly different ways. Both are prescribed for adults with heterozygous familial hypercholesterolemia (HeFH).
Repatha may also be prescribed for HeFH in children aged 10 years or older, and for adults and certain children with homozygous familial hypercholesterolemia (HoFH). Additionally, Repatha is approved to reduce the risk of heart attack and stroke in adults with specific types of heart disease.
Both drugs are administered via subcutaneous injection. Leqvio injections are given every six months after the initial two doses, while Repatha injections are typically given once every two or four weeks, and patients can be taught to self-administer Repatha at home.
Cost of Leqvio
The cost of Leqvio can vary significantly based on individual insurance coverage. Patients with questions about prescription costs or payment options should consult their healthcare provider or pharmacist. Support programs may also be available to assist with the cost.
Important Considerations Before Starting Leqvio
Before initiating treatment with Leqvio, several factors should be discussed with a healthcare provider or pharmacist.
Pregnancy
The safety of Leqvio during pregnancy is not established, as studies on its use in pregnant individuals are lacking. Cholesterol is essential for fetal development, and because Leqvio lowers cholesterol, it could potentially harm a fetus if administered during pregnancy. Therefore, healthcare providers typically do not prescribe Leqvio to pregnant individuals. Those who are pregnant or planning a pregnancy should discuss alternative treatment options with their doctor. If pregnancy occurs while using Leqvio, treatment will likely be discontinued.
Breastfeeding
It is unknown whether Leqvio is safe to use while breastfeeding, as it is not known if the drug passes into breast milk or could affect a breastfed child. Individuals who are breastfeeding or planning to breastfeed should consult their healthcare provider about their options.
Precautions
Individuals with a history of allergic reaction to Leqvio or any of its components will likely not be prescribed the medication. Additionally, Leqvio has not been studied in individuals with severe liver problems, so its safety and effectiveness in this population are unknown. Patients with severe liver conditions should discuss with their doctor whether Leqvio is an appropriate treatment option.
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