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Anatomical cross-section of a human artery showing cholesterol plaque buildup and restricted blood flow. 3d illustration<\/p>\n
getty<\/p>\n
If your cholesterol has remained persistently elevated despite taking a statin, you may have heard your health care provider mention drugs like Repatha or Praluent<\/a> \u2014 injections that block a protein called PCSK9 <\/a>and help your liver pull more \u201cbad\u201d LDL cholesterol out of your blood. <\/p>\n On July 16, 2026, the FDA approved <\/a>the first pill version of this same idea: Lipfendra (enlicitide), a once-daily tablet for adults with high cholesterol (LDL-C), including an inherited form called familial hypercholesterolemia.<\/p>\n \u201cThis is an incredible breakthrough in heart disease prevention and care. This revolutionary new oral medication allows us to get LDL cholesterol levels (so called \u201dbad cholesterol”) to levels we have never seen before with oral medications.” said Dr. Mohammed Alo,<\/a> Assistant Clinical Professor of Medicine at Midwestern University Downers Grove, Illinois, Assistant Clinical Professor of Medicine at Ohio University Athens, Ohio. Dr. Alo is known for providing concise and clear public messaging<\/a> managing lipid disorders and other complex cardiac conditions.<\/p>\n How Well Does iIt Work?<\/p>\n In two large studies, Lipfendra lowered LDL cholesterol (LDL-C) by more than half compared with a placebo \u2014 a 56% reduction in one trial<\/a> of adults with heart disease or high risk for it, and a 59% reduction in a second trial<\/a> of people with the inherited form of high cholesterol. It also improved other cholesterol-related markers health care providers monitor, including ApoB<\/a> and non-HDL cholesterol. Those numbers are in the same range as what the injectable drugs achieve, which is notable for a pill.<\/p>\n Dr. Abeer Berry<\/a>, Director of Noninvasive Cardiology, DMC Huron Valley Sinai Hospital strongly agreed. \u201cWe are one step closer to eradicating heart disease. As of July 16, the first oral PCSK9 inhibitor has been approved for consumer use. This once daily oral tablet is capable of lowering your LDL cholesterol, also known as your ‘bad cholesterol,\u2019 by nearly 60%.” <\/p>\n What About Lp(a)?<\/p>\n Lp(a)<\/a>, short for lipoprotein(a), is a lesser-known, highly atherogenic and inherited cholesterol-like particle that raises the risk of coronary artery disease (CAD), heart attacks, strokes along with risk for aortic valve abnormalities–but isn\u2019t affected by diet, exercise, or statins. The good news: Lipfendra lowered Lp(a) too, by roughly a quarter in the main trials. The important caveat is that this isn\u2019t unique to Lipfendra \u2014 the injectable PCSK9 drugs (Repatha, Praluent) and a couple of other newer agents all lower Lp(a) by a similar amount, around 25%. So if a very high Lp(a) is your main concern, Lipfendra doesn’t outperform what’s already available; it simply offers the same modest benefit in pill form. Medicines designed specifically to target Lp(a) are still being tested and aren’t approved yet.<\/p>\n Cholesterol formation, fat, artery, vein, heart. Red blood cells, blood flow. Narrowing of a vein for fat formation. Surgery operation, 3d render<\/p>\n gettyLipfendra Vs. Repatha: What\u2019s The Real Difference?<\/p>\n No study has pitted Lipfendra directly against Repatha (evolocumab) head-to-head, so comparisons are indirect. What we can say is this: the amount of LDL lowering looks similar between the two medications. The biggest practical difference is the form \u2014 a daily pill instead of an injection every two to four weeks \u2014 which may appeal to people who have fear of needles or find injection schedules challenging to keep up with.<\/p>\n \u201cThe effectiveness [of Lipfendra] is similar to an injectable PCSK9 inhibitor, which is most commonly administered every two weeks.\u201dadded Berry. <\/p>\n The biggest scientific difference, though, is track record. Repatha has been shown in a large, multi-year study<\/a> to actually reduce heart attacks and strokes– not just lower cholesterol numbers on a lab report. Lipfendra hasn\u2019t been tested long enough yet to know whether it does the same \u2014 that answer is expected from a large ongoing trial <\/a>with over 14,500 participants. Until those results are in, Lipfendra is approved only for lowering cholesterol–not (yet) for proven heart-attack or stroke prevention, even though experts expect it likely will show similar benefit given how closely it mirrors the injectable drugs.<\/p>\n Is It Safe?<\/p>\n In the larger trial, side effects with Lipfendra were similar to placebo. In the familial hypercholesterolemia trial, diarrhea (7% vs. 2% with placebo) and dizziness (9% vs. 4%) were somewhat more common, though similar numbers of people in each group stopped treatment because of side effects.<\/p>\n \u201cIn contrast to the injectable version, one can avoid possible injection site reactions and flu like symptoms but may expect possible diarrhea or dizziness.\u201d explained Berry. <\/p>\n The Bottom Line<\/p>\n Lipfendra is a genuine advance for people who need more LDL lowering than a statin alone provides and who would prefer a pill to an injection. It works about as well as the existing injectable options, including for Lp(a), but doesn’t yet have the long-term proof of preventing heart attacks that Repatha has. If your cholesterol remains high despite treatment, this is a good conversation to have with your doctor \u2014 including whether a pill-based option now makes sense for you.<\/p>\n \u201cWith this option of lipid lowering therapy, we are hopeful to continue to reduce the prevalence of cardiovascular disease – the number one cause of death in the United States,\u201d Berry emphasized. <\/p>\n","protected":false},"excerpt":{"rendered":"Anatomical cross-section of a human artery showing cholesterol plaque buildup and restricted blood flow. 3d illustration getty If…\n","protected":false},"author":3,"featured_media":942173,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_share_on_mastodon":"0"},"categories":[34],"tags":[210,133129,379431,1060,379429,379430,83150,379433,379432,67,132,68],"class_list":["post-942172","post","type-post","status-publish","format-standard","has-post-thumbnail","category-medication","tag-health","tag-ldl","tag-lipfendra","tag-medication","tag-new-pill-for-cholesterol","tag-novel-pill-for-cholesterol","tag-pcsk9","tag-praluent","tag-repatha","tag-united-states","tag-unitedstates","tag-us"],"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/116938074238365482","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/942172","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=942172"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/942172\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/942173"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=942172"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=942172"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=942172"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}