| Hypercholesterolemia
Nextletol vs Praluent
Side-by-side clinical, coverage, and cost comparison for hypercholesterolemia.Deep comparison between: Nexletol vs Praluent with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsPraluent has a higher rate of injection site reactions vs Nexletol based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Praluent but not Nexletol, including UnitedHealthcare
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Category
Nexletol
Praluent
At A Glance
Oral
Daily
ACL inhibitor
SC injection
Every 2-4 weeks
PCSK9 inhibitor
Indications
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Myocardial Infarction
- Coronary heart disease
- Cerebrovascular accident
- Angina, Unstable
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Homozygous Familial Hypercholesterolemia
Dosing
Hypercholesterolemia, Familial hypercholesterolemia - heterozygous 180 mg orally once daily with or without food; analyze lipid levels within 8 to 12 weeks after initiation.
Hypercholesterolemia, Myocardial Infarction, Coronary heart disease, Cerebrovascular accident, Angina, Unstable 75 mg SC once every 2 weeks or 300 mg SC once every 4 weeks; may adjust to 150 mg SC every 2 weeks if LDL-C response is inadequate.
Familial hypercholesterolemia - heterozygous (adults on LDL apheresis), Homozygous Familial Hypercholesterolemia 150 mg SC once every 2 weeks; may be administered without regard to timing of LDL apheresis.
Familial hypercholesterolemia - heterozygous (pediatric, <50 kg) 150 mg SC once every 4 weeks; may adjust to 75 mg SC once every 2 weeks if LDL-C response is inadequate.
Familial hypercholesterolemia - heterozygous (pediatric, >=50 kg) 300 mg SC once every 4 weeks; may adjust to 150 mg SC once every 2 weeks if LDL-C response is inadequate.
Contraindications
- Prior serious hypersensitivity reaction to bempedoic acid or any excipient in NEXLETOL
- Previous serious hypersensitivity reaction to alirocumab or any excipient in PRALUENT
Adverse Reactions
Most common (>=2%) Upper respiratory tract infection, muscle spasms, hyperuricemia, back pain, abdominal pain or discomfort, bronchitis, pain in extremity, anemia, elevated liver enzymes
Serious Hyperuricemia, tendon rupture
Postmarketing Angioedema, wheezing, rash, urticaria
Most common (>=2%) Injection site reactions, influenza, diarrhea, myalgia, muscle spasms, contusion
Serious Hypersensitivity vasculitis, nummular eczema, angioedema
Postmarketing Angioedema, influenza-like illness
Pharmacology
Bempedoic acid is an ACL inhibitor that lowers LDL-C by inhibiting cholesterol synthesis in the liver upstream of HMG-CoA reductase; it requires CoA activation by ACSVL1 (expressed primarily in the liver) and upregulates LDL receptors to reduce circulating LDL-C.
Alirocumab is a human monoclonal antibody that inhibits PCSK9, a protein that promotes LDL receptor degradation on hepatocytes, thereby increasing LDL receptor availability and lowering circulating LDL-C levels.
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Most Common Insurance
Anthem BCBS
Nexletol
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (11/12) · Qty limit (11/12)
Praluent
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Nexletol
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Praluent
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (1/8) · Qty limit (1/8)
Humana
Nexletol
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Praluent
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Nexletol.
$50/momo
MyPraluent Copay CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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NexletolView full Nexletol profile
PraluentView full Praluent profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.