Short answer: The Praluent label starting dose for adults with high cholesterol, including HeFH, is 75 mg every 2 weeks or 300 mg every 4 weeks, injected under the skin, with 150 mg every 2 weeks if LDL lowering is not enough. Adults with HoFH, or HeFH on LDL apheresis, use 150 mg every 2 weeks. Children 8 and older are dosed by weight. A missed dose is taken within 7 days.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Praluent is approved for: Praluent is a PCSK9 inhibitor approved to lower the risk of major heart and blood vessel events (death from coronary heart disease, heart attack, stroke, or unstable angina needing a hospital stay) in adults at increased risk, and, alongside diet and exercise, to lower LDL cholesterol in adults with high cholesterol, adults and children 8 and older with heterozygous familial hypercholesterolemia (HeFH), and adults with homozygous familial hypercholesterolemia (HoFH) (section 1).
Source
PRALUENT (alirocumab) injection, for subcutaneous use, prescribing information, Patient Information and Instructions for Use. Sanofi. DailyMed, version published July 24, 2026. DailyMed setid 446f6b5c-0dd4-44ff-9bc2-c2b41f2806b4
Praluent is injected under the skin of the thigh, abdomen or upper arm, rotating sites and avoiding skin that is tender, bruised, red or hard. An injection may take up to 20 seconds (section 2.4).
The 300 mg dose is given as two 150 mg injections in a row at two different sites (section 2.4). A refrigerated pen is warmed to room temperature for 30 to 40 minutes first.
Children 12 to 17 have it given by or under the supervision of an adult; children 8 to 11 have it given by a caregiver (section 2.4).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Who | Recommended dosage | If LDL-C response is inadequate |
|---|---|---|
| Adults with hypercholesterolemia, including HeFH | Starting dosage either 75 mg once every 2 weeks or 300 mg once every 4 weeks | 150 mg every 2 weeks |
| Adults with HeFH undergoing LDL apheresis or with HoFH | 150 mg once every 2 weeks | Not stated |
| Children 8 years and older with HeFH, body weight less than 50 kg | 150 mg once every 4 weeks | 75 mg once every 2 weeks |
| Children 8 years and older with HeFH, body weight 50 kg or more | 300 mg once every 4 weeks | 150 mg once every 2 weeks |
On 300 mg every 4 weeks, LDL cholesterol is measured just before the next scheduled dose, because it can vary between doses. LDL lowering can be measured as early as 4 weeks after starting.
Praluent can be given without regard to the timing of LDL apheresis.
No dose change is needed for mild or moderate kidney or liver impairment. There are no data in severe kidney or liver impairment (sections 8.6 and 8.7).
Praluent is refrigerated at 36 F to 46 F (2 C to 8 C) in the original carton, not frozen or shaken. It can be kept at room temperature up to 77 F (25 C) in the carton for 30 days, and is thrown away if not used in that time.
The label says, if a dose is missed: "Within 7 days from the missed dose, instruct the patient to administer PRALUENT and resume the patient's original schedule. For every 2-week dosage, instruct the patient to wait until the next dose on the original schedule. For every 4-week dosage, instruct the patient to administer the dose and start a new schedule based on this date." The Patient Information makes clear the last two apply when the dose was missed by more than 7 days.
More on this: missed a dose of Praluent.
In Dose Track you set up Praluent as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.