Short answer: If it has been 7 days or less since the missed dose, the Praluent label says to inject it and keep your original schedule. After more than 7 days: on an every-2-week schedule, wait for the next scheduled dose; on an every-4-week schedule, inject now and start a new schedule from that date.
| Situation | What the label says |
|---|---|
| Schedule | Every 2 weeks or every 4 weeks |
| Within 7 days of the missed dose | Inject it; keep the original schedule (2.3) |
| More than 7 days, every 2 weeks | Wait for the next dose on the original schedule (2.3) |
| More than 7 days, every 4 weeks | Inject it; start a new schedule from today (2.3) |
| Half-life | About 17 to 20 days at steady state (12.3) |
Section 2.3 says that within 7 days of the missed dose, inject Praluent and resume the original schedule. The Patient Information explains how: if you inject every 2 weeks, the next dose is 2 weeks from the day you missed; if every 4 weeks, 4 weeks from the day you missed.
Example: you inject every 2 weeks on Mondays and remember on Thursday (3 days late). Under the label you would inject Thursday and take the next dose on the original Monday, 2 weeks after the missed one.
Section 2.3 splits by schedule. Every 2 weeks: wait until the next dose on the original schedule. Every 4 weeks: inject the dose and start a new schedule from that date.
Example: on an every-4-week schedule, your dose was due on the 1st and you remember on the 10th. Under the label you would inject on the 10th and count 4 weeks from there.
Alirocumab has a median half-life of about 17 to 20 days at steady state, shorter (about 12 days) when taken with a statin (section 12.3). A few days late does not drop levels suddenly.
This page summarizes FDA labeling. It is not personalized medical advice; confirm what to do with your prescriber or pharmacist.