Inclisiran: a simple guide to a twice-yearly cholesterol shot
Want a treatment that can lower LDL cholesterol with two maintenance shots a year? That’s the promise of inclisiran (brand name Leqvio). It’s not a statin or antibody — it’s a small interfering RNA (siRNA) that tells the liver to make less PCSK9, a protein that raises LDL levels. Less PCSK9 usually means lower LDL and lower heart risk over time.
How inclisiran works and who it helps
Inclisiran targets the liver’s PCSK9 production. Reduced PCSK9 lets LDL receptors do their job better, pulling cholesterol out of the blood. Clinical trials show average LDL drops around 40–50% when inclisiran is added to standard therapy. Doctors usually consider it for adults who still have high LDL despite statins and ezetimibe, or for people who can’t tolerate statins. It’s approved for adults with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia in many places.
It’s given by subcutaneous injection on a loading schedule: first dose, a second dose at three months, then every six months after that. Because dosing is infrequent, many patients find adherence easier than daily pills.
What to expect: safety, monitoring, and practical tips
Common side effects are mild — injection-site reactions are the most reported. Serious side effects are rare in trials, but your doctor may check blood tests before or during treatment. If you have liver disease, discuss it with your clinician; they’ll advise whether monitoring is needed.
Practical tips: bring a current medication list to your appointment, ask about prior authorization or coverage rules if you use insurance, and ask if injections will be given at the clinic or taught for home use. If you’re pregnant, planning pregnancy, or breastfeeding, ask your provider — safety data are limited and most clinicians avoid use in those situations.
Alternatives to inclisiran include high-intensity statins, ezetimibe, and PCSK9 monoclonal antibodies (evolocumab, alirocumab). Each option has pros and cons: statins are cheap and proven, PCSK9 antibodies lower LDL strongly but require more frequent dosing, and inclisiran offers a middle path with infrequent injections and durable effect.
Questions to ask your doctor: How much LDL reduction can I expect? Who will give the injections and where? What does my insurance cover? What monitoring will you do? Getting clear answers helps you decide if inclisiran fits your treatment plan.
Inclisiran isn’t a miracle pill, but for the right person it’s an effective, low-maintenance way to cut LDL. Talk to a clinician who knows your heart risk, and weigh cost, convenience, and how much more LDL lowering you need.
Rosuvastatin isn't the only option for managing high cholesterol. This article dives into five alternatives, each with its own set of advantages and downsides. Whether you're seeking a different dosing schedule or looking for a treatment as a statin-intolerant patient, these alternatives may offer a solution. We'll unpack the pros and cons of each option to help you find the right fit for your health needs.
