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New Cholesterol Drugs in 2026: What Is Available

The newest cholesterol drugs in 2026 are Lipfendra, the first PCSK9 pill (approved July 2026), Lerochol, a monthly shot with a $199 cash price (launched May 2026), and Leqvio, a twice-a-year shot that no longer requires a statin first. Obicetrapib, Lp(a) drugs and gene editing remain in trials.

Estimate your LDL on each medicine
LDL goal
  • Repathaabout 52 mg/dL

    Average result would reach under 70.

  • Lipfendraabout 53 to 57 mg/dL

    Average result would reach under 70.

  • Praluentabout 55 to 70 mg/dL

    Average result would reach under 70.

  • Lerocholabout 57 mg/dL

    Average result would reach under 70.

  • Leqvioabout 65 mg/dL

    Average result would reach under 70.

  • Nexlizetabout 81 mg/dL

    Average result stays above 70. A second medicine can close the gap.

  • Ezetimibeabout 98 to 104 mg/dL

    Average result stays above 70. A second medicine can close the gap.

  • Nexletolabout 103 to 108 mg/dL

    Average result stays above 70. A second medicine can close the gap.

The dark line marks your goal. Starting LDL: 130 mg/dL.

Rough estimate. Trials report the average drop for one medicine, usually compared with placebo and often in people already on a statin, and your result can differ. Use the LDL you have now, on your current treatment. Your clinician sets your goal. Figures match the guides on this site; see each medicine’s guide for the sources.

What are the newest cholesterol medications in 2026?

Three are new or newly expanded: Lipfendra (approved July 2026), Lerochol (launched May 2026) and Leqvio, whose label now allows use on its own. All three act on PCSK9, a liver protein that destroys the receptors your liver uses to pull LDL out of the blood.

Repatha and Praluent have blocked PCSK9 for about a decade. The new versions come as a pill, a monthly shot and a twice-a-year shot.

Is there a new cholesterol pill?

Yes. Lipfendra (enlicitide) from Merck is the first PCSK9 inhibitor you take by mouth. It lowered LDL by about 56 to 59% more than placebo in phase 3 trials. You take one 20 mg tablet in the morning on an empty stomach, then wait at least 30 minutes before food.

Merck set the list price at $10.50 a day, about $315 a month. Its heart-outcomes trial, CORALreef Outcomes, is still running.

Nexlizet, a daily pill that combines bempedoic acid and ezetimibe, lowered LDL by 38% more than placebo in its label trial. The 2026 guideline moved bempedoic acid up to a first-line non-statin option.

Is there a new monthly injection for cholesterol?

Yes. Lerochol (lerodalcibep) is a once-a-month PCSK9 inhibitor you inject at home. The FDA approved it in December 2025, and it lowered LDL by 56% more than placebo in its year-long trial.

It launched May 11, 2026 with a direct cash price of $199 a month. An autoinjector pen was approved on August 17, 2026 and is expected by January 2027.

Two older shots changed too. Leqvio had its label updated in July 2025 and covers adults with high cholesterol with no statin requirement. Repatha gained VESALIUS-CV data, which showed a 25% lower risk of a first heart attack, stroke or coronary death in 12,257 people who had never had one.

What changed in the 2026 cholesterol guideline?

The 2026 ACC/AHA multisociety dyslipidemia guideline brought back specific LDL goals. For people with heart disease, the goal is an LDL-C under 70 mg/dL, and under 55 for those at very high risk.

When LDL stays above goal on a statin, it says adding ezetimibe and/or a PCSK9 inhibitor "should be implemented without delay." It notes PCSK9 inhibitors lower LDL by about 60% versus 15 to 20% for ezetimibe, elevates bempedoic acid to a first-line non-statin option, and describes inclisiran as "a valuable alternative for select patients requiring durable LDL-C lowering."

Which new cholesterol drugs are still in trials?

None of these are FDA-approved, and you can receive them only inside a clinical trial.

  • Obicetrapib, a once-daily CETP inhibitor pill. As of May 2026, its maker expected decisions in Europe, the UK and Switzerland in the second half of 2026, with PREVAIL outcomes results in early 2027. It is not approved in the US.
  • Lp(a) drugs. On September 4, 2026, Novartis reported that pelacarsen lowered Lp(a) but missed its primary endpoint of reducing cardiovascular events in Lp(a)HORIZON. Olpasiran, lepodisiran, zerlasiran and muvalaplin are in separate trials.
  • Gene editing. VERVE-102 is a one-time infusion designed to switch off the PCSK9 gene. A phase 1b study is recruiting, and a phase 2 study is listed as not yet recruiting.

Should I switch to a newer cholesterol drug?

Statins are inexpensive, have decades of outcomes data and remain the base of treatment for most people under the 2026 guideline. The newer drugs fit when LDL or ApoB stays above goal on a statin, when statins cause side effects, when you have familial hypercholesterolemia and need a large drop, or when you want a pill or fewer shots.

Repatha and Praluent are the PCSK9 options with completed outcomes trials. Ask your clinician which option fits your numbers and coverage.

Trials in this guide

Each links to a plain summary with a quote from the PubMed abstract.

  • VESALIUS-CV (2026) · Evolocumab · 12,257 peopleBenefit

Common questions

▸What is the newest cholesterol medication?

As of October 2026, Lipfendra (enlicitide), a once-daily PCSK9 pill from Merck approved in July 2026. It lowered LDL by about 56 to 59% versus placebo. Lerochol, a monthly PCSK9 shot, launched in May 2026.

▸Is obicetrapib FDA approved?

No. As of October 2026 it is not approved in the US. Its maker expected decisions in Europe, the UK and Switzerland in the second half of 2026, and PREVAIL is expected to report in early 2027.

▸Leqvio or Nexlizet after a statin?

Leqvio is a twice-a-year shot that lowered LDL by about 50% in its main trials. Nexlizet is a daily pill that lowered LDL by 38% in its label trial. The trials enrolled different patients, so ask your clinician how much LDL you need to lose.

▸Are the new cholesterol drugs better than statins?

They do a different job. The newer drugs are mostly add-ons, or options for people who can't take a statin, when LDL needs to come down further.

▸Is there a one-time gene-editing treatment for cholesterol?

Not one you can get. VERVE-102 is in early clinical trials as of October 2026, is not FDA-approved and is available only inside a study.

The full guideRead the complete, referenced version on Preval Health More detail, every study, and the date each figure was checked.

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Sources

Not medical advice. General education from published trials and drug labels, last updated October 2026. lipid.site is not a healthcare provider and cannot tell you what to take or change. Talk to your clinician before starting or stopping any treatment. If you have chest pain or other signs of a heart attack or stroke, call 911.