PCSK9 and familial hypercholesterolemia: Other medications, including ezetimibe, niacin, and fibrates, are similarly associated with teratogenicity and are thus contraindicated during pregnancy.33 Proprotein convertase subtilisin/kexin type 9 serine protease inhibitors have not been tested for safety during pregnancy and are not currently approved during pregnancy.33 Safe therapies are limited to bile acid sequestrants and LDL-C apheresis, both of which are only approved in women with severe familial hypercholesterolemia.33,39