• Posted November 13, 2025

New Merck Pill Cuts 'Bad' Cholesterol by 60%, Potentially Replacing Injections

A new pill from Merck could change how millions of people treat high cholesterol and help prevent heart attacks and strokes without the need for injections.

The drug, called enlicitide, slashes levels of harmful LDL cholesterol by up to 60%, similar to injectable PCSK9 drugs already on the market. 

The pill blocks a liver protein called PCSK9, which slows the body’s ability to clear cholesterol from the blood.

“Lower is better for sure,” University of Pennsylvania cardiologist Dr. Daniel Soffer told The New York Times. 

The 24-week trial included 2,912 adults who had a prior heart attack, stroke or other cardiovascular event, or were at high risk for one. 

Those who took enlicitide saw LDL cholesterol levels drop by as much as 60% compared with those who were given a placebo.

Researchers found no difference in side effects between the two groups.

Enlicitide could offer a simpler and more affordable alternative to the PCSK9 injections now on the market, such as Repatha, which is made by Amgen, and Praluent, made by Regeneron and Sanofi.

Dr. Dean Li, president of Merck Research Laboratories, told The Times that the company hopes to keep costs down and make the treatment as simple and routine as taking aspirin.

“The dream is to democratize PCSK9,” Li explained. “This dream has the possibility of coming true.”

Creating a pill to block PCSK9 has long been seen as impossible because the protein’s structure makes it hard for small molecules to target. 

Merck scientists spent 10 years developing a new type of substance — a circular peptide, about one-hundredth the size of an antibody — that can do what injections do but in pill form.

Li said the innovation could pave the way for other drugs that replace injectables.

Merck is now running a larger study involving more than 14,500 people to confirm whether the cholesterol reductions lead to fewer heart attacks, strokes and deaths. 

The company plans to apply for U.S. Food and Drug Administration (FDA) approval in early 2026 and hopes to launch the drug in 2027.

Dr. Christopher Cannon, a cardiologist at Brigham and Women’s Hospital in Boston, welcomed the development.

If the results hold up, he told The Times, this could "be a game changer.”

More information

The Cleveland Clinic has more on PCSK9 inhibitors.

SOURCE: The New York Times, Nov. 8, 2025