alirocumab vs evolocumab
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of alirocumab and evolocumab. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Praluent
Repatha
Praluent is a medicine that can lower cholesterol. It can also lower the risk of heart problems like heart attack or stroke in some adults.
Repatha is a medicine that can lower cholesterol. It can also lower the risk of heart problems like heart attack and stroke.
Praluent is used to lower LDL cholesterol (bad cholesterol). It is used along with diet and exercise in adults with high cholesterol. It is also used in adults and children 8 years and older who have a genetic condition that causes high cholesterol.
Repatha helps lower LDL cholesterol (bad cholesterol) in adults and children aged 10 and older. It is used along with diet and exercise. It can help people with high cholesterol or inherited high cholesterol (HeFH and HoFH). Repatha also helps reduce the risk of major heart problems in adults at high risk.
Praluent is a PCSK9 inhibitor. It works by blocking a protein in your body called PCSK9. Blocking this protein helps your body remove LDL cholesterol from your blood.
Repatha is a PCSK9 inhibitor. It works by blocking a protein called PCSK9 in your body. Blocking PCSK9 helps your liver remove more cholesterol from your blood, which lowers your cholesterol levels.
- • Injection site reactions (redness, itching, swelling, pain)
- • Flu
- • Muscle pain
- • Diarrhea
- • Common cold
- • Upper respiratory infection
- • Flu
- • Back pain
- • Injection site reactions (redness, pain, bruising)
- Myalgia 1,655
- Product Dose Omission 1,364
- Injection Site Pain 1,278
- Muscle Spasms 1,162
- Arthralgia 1,053
- Device Difficult To Use 32,421
- Drug Dose Omission By Device 24,327
- Accidental Exposure To Product 16,287
- Injection Site Pain 10,340
- Product Storage Error 6,630
Serious allergic reactions have happened with Praluent, sometimes requiring hospitalization. If you have signs of a serious allergic reaction, stop using Praluent and get medical help right away.
Serious allergic reactions, including swelling of the face, mouth, and tongue (angioedema), have happened with Repatha. If you have any signs of a serious allergic reaction, stop using Repatha and get medical help right away. Some Repatha pens and syringes have latex in the needle cover. Tell your doctor if you are allergic to latex.
There is not enough information about Praluent use during pregnancy to know if it is safe. If you are pregnant or plan to become pregnant, talk to your doctor before using Praluent.
It is not known if Repatha will harm your unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known if Repatha passes into breast milk. Talk to your doctor about the best way to feed your baby if you are using Repatha.
How to Read This alirocumab vs evolocumab Comparison
alirocumab is classified in the PCSK9 Inhibitor drug class, while evolocumab sits within the PCSK9 Inhibitor class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, alirocumab has 6,512 submissions while evolocumab has 90,005. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for alirocumab or evolocumab.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.