| Hypercholesterolemia
Nexlizet vs Praluent
Side-by-side clinical, coverage, and cost comparison for hypercholesterolemia.Deep comparison between: Nexlizet 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 Nexlizet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Praluent but not Nexlizet, including UnitedHealthcare
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Category
Nexlizet
Praluent
At A Glance
Oral
Daily
ACL inhibitor / cholesterol absorption inhibitor
SC injection
Every 2-4 weeks
PCSK9 inhibitor
Indications
- Hypercholesterolemia
- Atherosclerosis
- Myocardial Infarction
- Coronary heart disease
- Cerebrovascular accident
- Angina, Unstable
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Homozygous Familial Hypercholesterolemia
Dosing
Hypercholesterolemia, Atherosclerosis One tablet (180 mg bempedoic acid and 10 mg ezetimibe) orally once daily, with or without food.
Coadministration with bile acid sequestrants Administer at least 2 hours before or at least 4 hours after bile acid sequestrants.
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 hypersensitivity to ezetimibe or bempedoic acid or any of the excipients in NEXLIZET
- 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, diarrhea, arthralgia, sinusitis, fatigue, influenza
Serious Hyperuricemia, tendon rupture
Postmarketing Thrombocytopenia, abdominal pain, pancreatitis, nausea, hepatitis, cholelithiasis, cholecystitis, anaphylaxis, angioedema, myopathy/rhabdomyolysis, dizziness, paresthesia, depression, headache, erythema multiforme
Most common (>=2%) Injection site reactions, influenza, diarrhea, myalgia, muscle spasms, contusion
Serious Hypersensitivity vasculitis, nummular eczema, angioedema
Postmarketing Angioedema, influenza-like illness
Pharmacology
NEXLIZET combines bempedoic acid, an ACL inhibitor that lowers LDL-C by blocking hepatic cholesterol synthesis upstream of HMG-CoA reductase via inhibition of ATP-citrate lyase, with ezetimibe, which reduces LDL-C by inhibiting intestinal cholesterol absorption via the NPC1L1 sterol transporter, together acting through complementary mechanisms to decrease 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
Nexlizet
- 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
Nexlizet
- 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
Nexlizet
- 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 Nexlizet.
$50/momo
MyPraluent Copay CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.