Understanding Cholesterol-Lowering Injections
Cholesterol-lowering injections reduce levels of low-density lipoprotein (LDL) cholesterol, often called “bad” cholesterol. These injectable therapies are typically considered when oral medications, such as statins, do not adequately lower cholesterol or when patients cannot tolerate them due to side effects. They offer an alternative approach to managing lipid levels and reducing the risk of cardiovascular events.
The primary types of cholesterol-lowering injections are PCSK9 inhibitors and inclisiran. PCSK9 inhibitors, like alirocumab (Praluent) and evolocumab (Repatha), are monoclonal antibodies. They work by binding to a protein called PCSK9, preventing it from breaking down LDL receptors on liver cells. This action allows more LDL receptors to remain active, enhancing the liver’s ability to remove LDL cholesterol from the bloodstream. These are usually self-injected every two to four weeks.
Inclisiran (Leqvio) operates through a different mechanism, using small interfering RNA (siRNA) to block the production of the PCSK9 protein within liver cells. By preventing PCSK9 from being made, inclisiran also increases the number of LDL receptors available to clear cholesterol from the blood. This medication is administered by a healthcare provider, initially with two doses three months apart, followed by injections every six months.
Common Side Effects
Cholesterol-lowering injections can cause common side effects, which are generally mild and temporary. The most frequently reported reactions occur at the injection site. These can include pain, redness, swelling, bruising, and itching. Such reactions are typically transient, resolving within a few days.
Flu-like symptoms are another common side effect. These symptoms may encompass headache, body aches, and a general feeling of fatigue. Additionally, upper respiratory tract infections, resembling a common cold or bronchitis, have been observed. These infections are usually mild to moderate in severity.
Muscle and back pain are also common side effects. Joint pain can also occur. While these discomforts are generally manageable, they represent a notable consideration for patients starting therapy.
Serious or Less Common Side Effects
While most side effects are mild, cholesterol-lowering injections can, in rare instances, lead to more serious reactions. Allergic reactions, though uncommon, warrant immediate medical attention. Symptoms can include hives, rash, difficulty breathing, or swelling of the face, lips, tongue, or throat.
Neurocognitive effects, such as memory impairment or confusion, have been rarely reported. Monitoring for any unusual neurological changes is important. Liver enzyme elevations have also been noted in rare instances, though significant changes are not common.
Less common side effects can also include urinary tract infections and diarrhea, particularly with inclisiran. While typically not severe, these can be bothersome.
Managing and Reporting Side Effects
Managing side effects from cholesterol-lowering injections involves open communication with a healthcare provider. For mild injection site reactions, applying a cold compress to the affected area can help alleviate discomfort, swelling, and redness. Persistent or worsening common side effects, or any signs of a serious reaction, should prompt immediate contact with a doctor. This includes symptoms like severe pain, difficulty breathing, or widespread rash.
Patients should discuss any concerns or new symptoms with their doctor, as adjustments to treatment or further evaluation may be necessary. Healthcare providers can offer guidance on managing specific side effects and determine if the medication needs to be altered. Maintaining regular follow-up appointments allows for ongoing monitoring of the medication’s effectiveness and safety.
For drug safety surveillance, patients and healthcare professionals can report adverse events to regulatory bodies. In the United States, for example, the FDA’s MedWatch program allows for the voluntary reporting of serious problems suspected to be associated with medical products. This process helps gather important information about drug safety in the broader population.