New Oral Drug Dramatically Lowers Cholesterol, Offering Potential Choice to Injections
São Paulo, Brazil – November 16, 2025 – In a potential breakthrough for cardiovascular health, pharmaceutical company Merck has developed an oral medication capable of reducing “bad” cholesterol (LDL) to remarkably low levels, offering a possible alternative to costly and inconvenient injectable drugs. The pill targets PCSK9, a protein that prevents the liver from removing LDL cholesterol from the blood.
For years, lowering LDL cholesterol has relied heavily on statins, but many patients require additional therapies to reach recommended levels. Current options often involve PCSK9 inhibitors, which are administered via injection. Merck’s new drug, enlicitid, represents a meaningful step towards a more accessible and affordable treatment.
The challenge in creating a pill-form PCSK9 inhibitor lay in the size of the molecule. Conventional small-molecule drugs are easily absorbed, but PCSK9 inhibitors are large proteins.”Getting a large molecule like those in most pills, would be very small,” explained researchers. Merck’s solution, after a decade of research, involved creating a circle of peptides – one-hundredth the size of an antibody but larger than a typical small molecule.
“This method could allow researchers to create pills that could replace many other injectable medications,” stated Dean Li, president of Merck Research Laboratories. He emphasized the economic benefits, noting that pills are cheaper to manufacture and transport than injectables, which require refrigeration. Merck aims to price enlicitid competitively, making it widely available in the United States and globally, envisioning a future where taking the pill is “no different than aspirin” or standard blood pressure medication.
“The dream is to democratize PCSK9,” Li said. ”This dream has the possibility of becoming reality.”
Cardiologists are optimistic about the potential impact. “It could be a game changer,” said Christopher Cannon, a cardiologist at Brigham and Women’s Hospital in Boston, who is not affiliated with Merck. David Maron, a preventative cardiologist at Stanford University, added, “If they price this so people can afford it, it will make a huge difference” for the millions at risk of heart attacks and strokes. “This is a really crucial advance.”
AstraZeneca is also developing a PCSK9 pill, according to Maron, who is involved in monitoring the safety of these drugs in clinical trials.
Merck is currently conducting a large-scale study involving over 14,500 participants to confirm that lowering LDL cholesterol with enlicitid translates into fewer heart attacks,strokes,and cardiovascular deaths. The company plans to submit the drug for U.S. food and Drug Administration approval in early 2026, with an anticipated launch in 2027.
