Does Praluent Cause Muscle Aches?
Yes, muscle aches (myalgia) are a reported side effect of Praluent (alirocumab), occurring in about 5% of patients in clinical trials, compared to 3% on placebo.[1] The FDA label lists it under musculoskeletal disorders, typically mild and resolving without stopping treatment.[1]
How Common Are Muscle Aches with Praluent?
In the ODYSSEY trials, myalgia affected 4.8% of Praluent users versus 3.1% on placebo, with back pain at 4.3% versus 2.7%.[2] Rates are similar across doses (75 mg or 150 mg every two weeks). It's less frequent than with statins but can occur alone or combined with other drugs.
Why Do Muscle Aches Happen with Praluent?
Praluent inhibits PCSK9 to lower LDL cholesterol, which doesn't directly damage muscles like statins. Aches may stem from lowered cholesterol affecting cell membranes or inflammation, though the exact mechanism is unclear.[3] Risk rises with concurrent statins (up to 7-8% myalgia rate).[1]
What Should You Do If You Get Muscle Aches?
Monitor symptoms; most resolve spontaneously. Consult a doctor if pain persists, worsens, or includes weakness/dark urine (rhabdomyolysis risk, rare at <0.1%).[1] Dose reduction or switching to another PCSK9 inhibitor like Repatha may help.[4]
How Does This Compare to Repatha or Statins?
Praluent's myalgia rate (5%) matches Repatha (evolocumab, ~5%) but is lower than statins like atorvastatin (10-15%).[2][5] Unlike statins, Praluent rarely causes severe muscle damage (CK elevations >10x normal in <1%).[1]
Who Is Most at Risk?
Higher risk with age >65, female sex, low BMI, or statin co-use. Pre-existing muscle issues or hypothyroidism increase susceptibility.[3] No strong genetic links identified.
[1]: FDA Praluent Label
[2]: ODYSSEY Trial Data
[3]: PCSK9 Inhibitor Review, Lancet
[4]: Repatha Prescribing Info
[5]: Statin Myopathy Review, NEJM