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What is the mechanism of action for Leqvio (inclisiran)?

Medically reviewed by Carmen Pope, BPharm. Last updated on March 12, 2025.

Official answer

by Drugs.com

Leqvio works by stopping a protein called PCSK9 from being made.

  • PCSK9 normally breaks down receptors on liver cells that grab bad cholesterol (LDL-C) from your blood.
  • The more receptors you have, the more cholesterol your liver can remove from your bloodstream.
  • When PCSK9 is too active, fewer receptors are available, leaving more LDL-C floating in your blood.

Leqvio stops PCSK9 production by:

  • Blocking the instructions (mRNA) that tell your body to make PCSK9 (this is a unique way of working compared to other PCSK9 blockers)
  • Using special technology (siRNA) that targets just this one protein.

Easy treatment schedule

Unlike daily cholesterol medications your healthcare provider gives Leqvio as an injection under your skin.

  • After your first two doses, you only need it every 6 months.
  • It works alongside your daily statin medication but can be used alone.
  • It helps keep your cholesterol levels consistently low.

Overall effect

Leqvio's unique approach means:

  • More cholesterol receptors stay active on your liver cells
  • Your liver can remove more bad cholesterol from your blood
  • Your cholesterol levels go down and stay down
  • You get long-lasting results with just 2 treatments per year.
References
  • Leqvio (inclisiran) Prescribing Information. https://www.novartis.com/us-en/sites/novartis_us/files/leqvio.pdf
  • Leqvio (inclisiran) Patient Brochure. https://www.leqviohcp.com/sites/leqviohcp_com/files/documents/leqvio-patient-brochure-downloadable-english.pdf
  • What is Leqvio. Leqvio.com. https://www.leqvio.com/what-is-leqvio

Read next

What is the difference between Leqvio and Repatha?

Leqvio and Repatha are both injectable medicines that are used for the treatment of high cholesterol, by specifically lowering low density lipoprotein (LDL) levels. Although they both inhibit PCSK9 they work by different mechanisms. Repatha is a monoclonal antibody that binds directly to PCSK9 in the liver preventing it from binding to LDL receptors. Leqvio blocks the PCSK9 protein by interfering with the translation of PCSK9 messenger RNA. Both have the same result – and that is freeing up LDL receptors on the surface of liver cells which allows LDL cholesterol to be removed from the blood. Continue reading

What are PCSK9 Inhibitors and how do they work?

The PCSK9 inhibitors are used for the treatment of high-risk patients with elevated cholesterol, especially when statins aren't adequate. They work by blocking PCSK9, leaving more receptors available to capture your "bad" cholesterol (LDL) for break down and removal from the blood. Continue reading

Can Leqvio be taken without a statin?

Leqvio is typically prescribed with a statin, such as atorvastatin (Lipitor), rosuvastatin (Crestor), or pravastatin, in addition to a heart-healthy diet. Leqvio can be prescribed without a statin, if statins are not tolerated or contraindicated. In this situation, your doctor may recommend a different treatment to lower your cholesterol, such as ezetimibe (Zetia), or Leqvio may be used alone. Continue reading

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