Mechanism of action: Lerodalcibep balliculeVisual mnemonic: Lerodalcibep mascot “Leroy doll says beep (to lower cholesterol)” Pesky K-9 → PCSK9, which targets LDL receptors for destruction Albumin in the backpack → fused to albumin, which is why a monthly dose holds
What it isSmall recombinant PCSK9-binding fusion protein with human serum albumin — not an antibody; FDA-approved 2025 for hypercholesterolemia including HeFH.
Why this oneOnce-monthly small-volume subcutaneous injection with room-temperature stability up to three months distinguishes it from earlier PCSK9 therapies.
What limits itInjection-site reactions and access are the main practical constraints; no cardiovascular outcome data yet.
Molecular structure: Lerodalcibep
Lerodalcibep prescription history
Animated chart of estimated U.S. prescriptions per year, Lipid-lowering meds (1955–2026). Lerodalcibep enters in 2026.
Primary hypercholesterolemia incl. HeFH / ASCVD risk (indications section not in extract; population from trial descriptions)
Adults
SC: 300 mg once monthly
SC: 300 mg once monthly
300 mg once monthly
Renal Mild-moderate impairment (eGFR 30 to <90): no adjustment; severe (eGFR <30)/ESRD not studied
Hepatic Mild or moderate impairment: no adjustment; severe not studied
Instructions
Inject SC into abdomen or upper front thighs; back of upper arm only if given by caregiver/HCP; rotate sites; avoid tender, bruised, red, or indurated skin
If refrigerated, warm to room temperature (up to 25 C) for at least 30 min before use
Inspect: clear to slightly opalescent, brownish-yellow to amber; do not use if cloudy or contains particles
Push plunger fully until syringe is empty to deliver full 300 mg dose
Missed dose <7 days: give ASAP, keep original monthly schedule; missed >=7 days: give ASAP and start new monthly schedule from that date
Assess LDL-C when clinically indicated; effect measurable as early as 4 weeks after initiation
Available strengths
inj 300 mg/1.2 mL
Adverse reactions
Injection site reactions (12-18%)
Nasopharyngitis (13-15%)
Diarrhea (3%)
Nausea (2%)
Peripheral edema (2%)
Injection site reactions were the most frequent reason for discontinuation
Pregnancy Discontinue when pregnancy recognized (or weigh ongoing need); may cause fetal harm based on mechanism (lowers LDL-C/cholesterol-derived substances); treatment of hypercholesterolemia generally unnecessary during pregnancy
Lactation No human data; present in monkey milk — weigh benefits of breastfeeding against maternal need and infant risk
Cost
Lerodalcibep (LEROCHOL)
Strength
#/mo
generic $/unit
CostPlus
300 mg/1.2 mL
inj
per unit
not offered
NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Lerodalcibep is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.