diff --git a/storage/remote/otlptranslator/prometheusremotewrite/helper.go b/storage/remote/otlptranslator/prometheusremotewrite/helper.go
index 4c50099e06..b8c7817a84 100644
--- a/storage/remote/otlptranslator/prometheusremotewrite/helper.go
+++ b/storage/remote/otlptranslator/prometheusremotewrite/helper.go
@@ -88,7 +88,11 @@ func (c *PrometheusConverter) createAttributes(resource pcommon.Resource, attrib
 	c.scratchBuilder.Sort()
 	sortedLabels := c.scratchBuilder.Labels()
 
-	labelNamer := otlptranslator.LabelNamer{UTF8Allowed: settings.AllowUTF8}
+	labelNamer := otlptranslator.LabelNamer{
+		UTF8Allowed:                 settings.AllowUTF8,
+		UnderscoreLabelSanitization: settings.LabelNameUnderscoreLabelSanitization,
+		PreserveMultipleUnderscores: settings.LabelNamePreserveMultipleUnderscores,
+	}
 
 	if settings.AllowUTF8 {
 		// UTF8 is allowed, so conflicts aren't possible.
diff --git a/storage/remote/otlptranslator/prometheusremotewrite/metrics_to_prw.go b/storage/remote/otlptranslator/prometheusremotewrite/metrics_to_prw.go
index 3dfd54cc9f..7083ce0885 100644
--- a/storage/remote/otlptranslator/prometheusremotewrite/metrics_to_prw.go
+++ b/storage/remote/otlptranslator/prometheusremotewrite/metrics_to_prw.go
@@ -54,6 +54,12 @@ type Settings struct {
 	// PromoteScopeMetadata controls whether to promote OTel scope metadata to metric labels.
 	PromoteScopeMetadata    bool
 	EnableTypeAndUnitLabels bool
+	// LabelNameUnderscoreLabelSanitization controls whether to enable prepending of 'key' to labels
+	// starting with '_'. Reserved labels starting with `__` are not modified.
+	LabelNameUnderscoreLabelSanitization bool
+	// LabelNamePreserveMultipleUnderscores enables preserving of multiple
+	// consecutive underscores in label names when AllowUTF8 is false.
+	LabelNamePreserveMultipleUnderscores bool
 }
 
 // PrometheusConverter converts from OTel write format to Prometheus remote write format.