Repatha (evolocumab)

Repatha is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) for the following uses.

• Reduce low-density lipoprotein (LDL) cholesterol. Repatha is used to lower LDL cholesterol in people who have certain forms of high cholesterol. Repatha may be prescribed alone or in combination with a cholesterol-lowering diet or other cholesterol-lowering medications. Doctors may prescribe Repatha for this use in:
  • adults with primary hyperlipidemia
  • adults and children ages 10 years and older with a certain type of familial (inherited) hypercholesterolemia
• Lower the risk of stroke, heart attack, or need for certain heart procedures. Repatha is used to reduce the risk of stroke, heart attack, or need for certain heart procedures in adults with cardiovascular disease.

For more information about these conditions and how the drug is used for them, see the “Repatha: Uses” section below.

The following table provides key facts about Repatha.

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Repatha contains the active drug evolocumab, which is a biologic Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source . It only comes as a brand-name medication. Repatha isn’t currently available in a biosimilar form. A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug).

Biologic drugs are made from living cells. It’s not possible to copy these drugs exactly. A generic, on the other hand, refers to drugs made from chemicals. A generic is an exact copy of the active drug in a brand-name medication.

Biosimilars are considered as effective and safe as their parent drugs. Like generics, biosimilars may cost less than brand-name drugs.

As with most drugs, it’s possible to have side effects with Repatha. These can include some mild side effects, but also some serious ones.

To learn more about Repatha’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Repatha, you can do so through MedWatch.

Mild and serious side effects of Repatha are listed below. These lists do not include all of Repatha’s possible side effects.

Mild side effects* of Repatha may include:

• cough
• headache
• back pain
• urinary tract infection (UTI)
• injection site reactions, such as bruising, pain, and redness or discoloration
• digestive problems, such as diarrhea and nausea
• fatigue
• dizziness
• muscle spasms
• upper respiratory infections, such as influenza (the flu) or the common cold
• inflammation of the intestines and stomach, which may cause abdominal pain
• joint pain†
• muscle pain†

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

* This is not a complete list of Repatha’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† For more information about this side effect, see “Repatha’s side effects explained” below.

Serious side effects from Repatha aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Serious side effects, which are described in “Repatha’s side effects explained” below, can include:

• high blood pressure
• raised blood sugar level
• allergic reaction

Below, you can find detailed information about some of Repatha’s side effects. To learn more about other side effects of this medication, talk with your doctor. 

Repatha may cause raised blood sugar levels. It’s possible that having high blood sugar could lead to diabetes. In fact, diabetes was a common side effect in Repatha’s clinical studies. To learn more about how often this side effect occurred, see the drug’s prescribing information.

Symptoms of high blood sugar and diabetes can include:

• fatigue
• blurry vision
• increased hunger or thirst
• frequent urination
• dry mouth

If you have symptoms of high blood sugar or diabetes while taking Repatha, talk with your doctor. They may order certain tests to check your average blood sugar levels over time. And they’ll recommend what to do if you have high blood sugar or diabetes.

Joint pain was a less common side effect in clinical studies of Repatha. To learn more about how often this side effect occurred in clinical studies, see the drug’s prescribing information.

Keep in mind that aches and pains are also symptoms of fatigue, which is another possible side effect of Repatha.

If you have bothersome joint pain with Repatha, talk with your doctor. They may suggest treatments to help ease your symptoms.

You may also find that over-the-counter (OTC) pain relievers help lessen your symptoms. Examples of OTC pain relievers include ibuprofen (Advil) and acetaminophen (Tylenol). However, before taking any OTC medications, check with your doctor or pharmacist to be sure they’re safe to take with Repatha.

Muscle pain was a less common side effect in clinical studies of Repatha. To learn more about how often this side effect occurred in clinical studies, see the drug’s prescribing information.

In some cases, doctors may prescribe Repatha in combination with other cholesterol-lowering medications. This includes statins, which may cause muscle damage leading to muscle pain. An example of a statin is simvastatin (Zocor). Taking these medications could worsen any muscle pain that Repatha may cause on its own.

If you have muscle pain while taking Repatha, talk with your doctor. It’s important to tell them if you have muscle pain while taking Repatha in combination with a statin. They may order certain blood tests to check for serious muscle damage.

Like other medications, prices for Repatha may vary. The drug’s price will depend on factors such as:

• the pharmacy you use
• your insurance coverage

Here’s a list of things to consider when looking into the cost of Repatha.

• Option for a 90-day supply. For some drugs, it’s possible to get a 90-day supply. If this option is approved by your insurance company, it can help lower the cost of the drug. It can also help you avoid frequent trips to your pharmacy. If you’d like to learn more about this option, ask your doctor, pharmacist, or insurance company.
• Need for prior authorization. Before insurance coverage for Repatha is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Repatha. Then, the insurance company will decide if the drug will be covered. To find out if you need prior authorization for Repatha, contact your insurance company.
• Possible cost assistance options. Financial assistance to help lower the cost of Repatha is available. Amgen, Inc., the manufacturer of the drug, offers ways to save on this drug. To learn more and see if you’re eligible for support, call 844-REPATHA (844-737-2842) or visit the manufacturer’s website. Also, check out this article to learn about ways to save on prescription drugs.
• Use of a specialty pharmacy. Repatha may be dispensed from specialty pharmacies. These pharmacies are authorized to handle certain drugs considered specialty medications. These medications may be expensive or require help from healthcare professionals to be used safely and effectively. Ask your doctor if they’ll prescribe Repatha through a specialty pharmacy.
• Availability of a biosimilar form. Repatha is a biologic Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source drug. It doesn’t come in a biosimilar form. A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug). Biosimilars may cost less than brand-name drugs.

Below, you’ll find dosages that are commonly recommended for Repatha. However, you should follow the dosing instructions your doctor gives you. They’ll recommend the dosage that’s best for your needs.

The dosage of Repatha that your doctor prescribes will depend on factors such as:

• your age
• the condition you’re using Repatha to treat and the severity of the condition

Repatha is given as a subcutaneous injection. It’s available as follows.

• Forms:
  • solution inside prefilled syringes
  • solution inside prefilled autoinjectors called Repatha SureClick
  • solution inside cartridges to be used with the Pushtronex system, which is an infusor that attaches to your body and injects the drug over a period of about 5 minutes
• Strengths:
  • 140 milligrams per milliliter (mg/mL) in syringes and autoinjectors
  • 420 mg/3.5 mL in cartridges

Recommended dosages for Repatha in adults and children are described below.

Repatha is typically injected either monthly or biweekly (once every 2 weeks). Your doctor can recommend the dosing schedule that’s best for you.

Repatha is used to reduce low-density lipoprotein (LDL) cholesterol in adults with certain forms of high cholesterol. Repatha is also used to lower certain risks in adults with heart disease. To learn more about the conditions listed here, see the “Repatha: Uses” section below.

Recommended dosages for treating these conditions in adults are as follows.

Repatha is used to lower LDL cholesterol in children ages 10 years and older with certain forms of high cholesterol. To learn more about the conditions listed here, see the “Repatha: Uses” section below.

Recommended dosages for treating these conditions in children are as follows.

Below are some things to consider about Repatha’s dosage.

Missing a dose. If you miss a dose of Repatha, take your missed dose within 7 days. Then you can go back to your normal dosing schedule.

However, if it’s been more than 7 days since your missed dose, what you’ll do depends on how often you normally inject Repatha. Here’s some general guidance:

• If you take the drug every 2 weeks, you’ll skip your missed dose. Then you’ll take your next dose at its usual time.
• If you use Repatha once every month, go ahead and inject your missed dose. Then use that date to start your new monthly schedule. For example, if you inject your missed dose on the 15th of the month, then you’ll inject your next dose on the 15th of the following month.

View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.

Length of treatment. Doctors typically prescribe Repatha as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition.

Doctors may prescribe drugs other than Repatha for your condition. Certain drugs may work better for you than others.

In addition to reducing certain risks in people with cardiovascular disease, Repatha is used to treat certain forms of high cholesterol. Here’s a summary of other drugs that doctors sometimes prescribe for this condition.

To learn more about some alternatives of Repatha, view the following articles:

• Repatha vs. Praluent
• Repatha vs. Crestor

Your doctor can tell you about other similar drugs, such as the statin drug atorvastatin (Lipitor).  

To learn more about alternatives to Repatha, ask your doctor. They can tell you about other medications that could be prescribed for your condition.

Here are some common questions about Repatha and brief answers to them. If you’d like to know more about these topics, ask your doctor.

No, Repatha isn’t a statin drug. Instead, Repatha belongs to a class of drugs called PCSK9 inhibitors.

Like Repatha, statins are used to treat high cholesterol. Examples of statin drugs include:

• pitavastatin (Livalo)
• simvastatin (Zocor)
• atorvastatin (Lipitor)
• rosuvastatin (Crestor)

Doctors may prescribe Repatha in combination with other cholesterol-lowering medications, including statins.

To learn more about how Repatha compares with statins, talk with your doctor or pharmacist. For a direct comparison of Repatha and the statin Crestor, see this article.

Most likely, no. Weight loss, hair loss, and memory loss weren’t reported as side effects in clinical studies of Repatha.

Keep in mind that doctors may prescribe Repatha in combination with other cholesterol-lowering medications. This includes statin drugs, which may cause hair loss or memory loss as a side effect. (To see a list of statins, view the question directly above.) You may have hair loss or memory loss while taking Repatha with these medications. But Repatha itself isn’t likely to be the cause.

Repatha may also be prescribed along with a cholesterol-lowering diet. Making these changes to your diet could lead to weight loss. In addition, Repatha may cause digestive problems as side effects. These include diarrhea and nausea. Long lasting or bothersome digestive problems could lead to loss of appetite, which may result in weight loss.

If you have other questions about weight loss, hair loss, or memory loss with Repatha, talk with your doctor or pharmacist.

Probably not. Liver disease, kidney disease, and pancreatitis (inflammation of the pancreas) weren’t reported in clinical studies of Repatha.

However, other cholesterol-lowering drugs may cause pancreatitis and certain liver or kidney problems. This includes statin drugs, such as atorvastatin (Lipitor) and rosuvastatin (Crestor), for example.

Statins may also cause rhabdomyolysis (muscle breakdown) and changes in levels of liver enzymes (certain proteins). In severe cases, rhabdomyolysis could lead to kidney failure.

Doctors may prescribe Repatha in combination with statins. While taking these medications together, you may experience certain liver, kidney, or pancreas problems. However, Repatha itself isn’t thought to cause these side effects.

If you have questions about what to expect with Repatha or other cholesterol-lowering drugs, talk with your doctor.

Using Repatha may cause an increased blood sugar level, which could lead to diabetes. In fact, diabetes was a common side effect in clinical studies of Repatha. For details, see “Repatha side effects explained” in the “Repatha: Side effects” section above.

If you have diabetes and you’re interested in taking Repatha, talk with your doctor. They’ll advise if it’s safe for you to use the drug. If your doctor feels it’s safe for you to take Repatha, they may have you watch your blood sugar levels more closely than usual.

Depression wasn’t reported as a side effect in clinical studies of Repatha. However, fatigue is a possible side effect of Repatha. And tiredness can be a symptom of fatigue.

If you’re concerned about tiredness or depression with Repatha, talk with your doctor.

Repatha is approved to reduce low-density lipoprotein (LDL) cholesterol in certain situations. It’s also approved to lower the risk of stroke, heart attack, or need for certain heart procedures in people with cardiovascular disease. For more information, see the “Repatha: Uses” section below.

Clinical studies have shown Repatha to be effective for these uses. To learn more about how the drug performed in these studies, see Repatha’s prescribing information. You can also visit the manufacturer’s site for details about the drug’s effectiveness.

Prescription drugs, such as Repatha, are approved by the Food and Drug Administration (FDA) to treat certain conditions.

The FDA has approved Repatha to reduce low-density lipoprotein (LDL) cholesterol, often called “bad cholesterol.”

Having a high level of LDL cholesterol doesn’t usually cause any symptoms. Doctors will use a blood test called a lipid panel to determine whether you have high cholesterol.

Doctors can prescribe Repatha to reduce LDL in:

• Adults with primary hyperlipidemia. This is a familial (inherited) condition that causes high cholesterol. An example of primary hyperlipidemia is heterozygous familial hypercholesterolemia (HeFH).
• Adults and children ages 10 years or older with certain types of familial hypercholesterolemia. This includes HeFH and homozygous familial hypercholesterolemia (HoFH).

For adults with primary hyperlipidemia, including HeFH, doctors will prescribe Repatha with a cholesterol-lowering diet. They may also prescribe Repatha alone or in combination with other cholesterol-lowering medications.

For children with HeFH, doctors will prescribe Repatha with a cholesterol-lowering diet and other cholesterol-lowering medications.

For adults and children with HoFH, doctors will prescribe Repatha in combination with other cholesterol-lowering medications.

The FDA has approved Repatha to reduce the risk of stroke, heart attack, or need for certain heart procedures such as heart bypass surgery. Doctors can prescribe Repatha for this purpose in adults with cardiovascular disease.

Below are a few examples of complications related to cardiovascular disease:

• stroke
• peripheral vascular disease
• coronary artery disease
• heart attack

Having high cholesterol can increase your risk of complications from cardiovascular disease. By reducing cholesterol levels, Repatha helps lower the risk of these complications in people with cardiovascular disease.

Repatha is used to lower LDL cholesterol in people who have certain forms of high cholesterol. It’s also used to reduce certain risks in people with cardiovascular disease.

Depending on the form of high cholesterol being treated, doctors may prescribe the drug in combination with a cholesterol-lowering diet. Or, they may prescribe Repatha with other cholesterol-lowering medications. An example is statins, such as simvastatin (Zocor) and atorvastatin (Lipitor).

Your doctor will recommend if you should take Repatha with other treatments.

The FDA has approved Repatha to lower LDL cholesterol in children with certain forms of high cholesterol. For details, see “Using Repatha for lowering LDL cholesterol in certain people” above.

If you’re interested in taking Repatha, you can find a doctor who might prescribe it by searching here. You can prepare for your appointment by viewing Healthgrades’ appointment guide for high cholesterol.

Repatha is approved to:

• reduce low-density lipoprotein (LDL) cholesterol in people with certain forms of high cholesterol
• lower the risk of stroke, heart attack, or need for certain heart procedures in adults with cardiovascular disease

To learn more about how Repatha is used, see the “Repatha: Uses” section above.

Cholesterol is a fatty substance. It can be found in foods such as meat, eggs, and cheese.

In addition, cholesterol is found naturally in your body. It’s made in your liver, which also helps remove cholesterol from your body.

Your body uses cholesterol for important functions, such as making hormones. However, having more cholesterol than your body is able to use can lead to serious problems. This includes cardiovascular disease and certain complications of it.

Repatha belongs to a group of drugs called PCSK9 inhibitors. It works by inhibiting (blocking) the activity of a protein called PCSK9, which is found in your liver. By blocking this protein, Repatha helps your liver remove more cholesterol from your body.

This lowers the level of LDL cholesterol in your body. It also helps lower your risk of complications from cardiovascular disease.

Repatha starts working as soon as you take it.

However, it may take several weeks for lower cholesterol levels to be seen on results of a lipid panel. Keep in mind that having a high cholesterol level typically doesn’t cause symptoms. So you’re not likely to notice the drug working for your condition.

Repatha may stay in your system for up to 3 months.

This is based on the half-life of Repatha, which is 11 to 17 days. (The half-life of a drug is the time it takes half of a drug’s dose to leave your body.)

It generally takes five half-lives for a drug to leave your system completely. For Repatha, this means the drug stays in your body for about 55 to 85 days.

Your doctor will recommend how you should take Repatha. It’s important that you take the drug exactly as your doctor instructs.

Repatha is given as a subcutaneous injection. It comes as a solution in three forms:

• prefilled syringes
• prefilled autoinjectors called Repatha SureClick
• prefilled cartridges to be used with the Pushtronex system, which is an infusor that attaches to the body and injects the drug over a period of about 5 minutes

Repatha can be injected into the following areas of your body:

• abdomen, if injected at least 2 inches away from the belly button
• thigh
• upper arm, if injected by a caregiver

Your doctor will show you or a caregiver how to inject Repatha. You can also visit the drug manufacturer’s website to view instructional videos on injecting Repatha.

Here’s a list of common questions related to taking Repatha.

• When should I take Repatha? You’ll likely take Repatha once or twice per month, depending on your doctor’s instructions. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Do I need to take Repatha with food? Repatha can be taken with or without food.
• Is there a best time of day to take Repatha? No, there isn’t a best time of day to take Repatha. The drug is typically injected one or two times each month. You can inject the drug any time of day.

Here’s some information about Repatha’s expiration date, as well as how to store and dispose of the drug.

• Expiration. Your pharmacist will add an expiration date to the label on Repatha’s packaging. This date is usually 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time. The Food and Drug Administration (FDA) advises Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source that you avoid using expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know whether you might still be able to use the medication.
• Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug. Repatha should be stored under refrigeration at a temperature between 36°F and 46°F (2°C and 8°C). You can also temporarily store Repatha at a room temperature between 68°F and 77°F (20°C and 25°C). When stored this way, Repatha’s shelf-life (how long it can stay at room temperature) is 30 days. Avoid storing it in areas where it could get damp or wet, such as bathrooms. The medication should be kept away from light and stored in its original container.
• Disposal. Dispose of any used syringes, needles, or autoinjectors right after using them. You can safely dispose of these items in an FDA-approved sharps container Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source . Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps them avoid harm from needles. If you’d like to buy a sharps container, you can find options online. Or ask your doctor, pharmacist, or health insurance company where you can purchase one. Your pharmacist can tell you more information about disposing of Repatha. Also, check out this page for several tips on safe medication disposal.

There isn’t a known interaction between Repatha and alcohol. If you drink alcohol, your doctor can recommend an amount that’s safe to drink during Repatha treatment.

Repatha isn’t known to interact with other medications, supplements, or foods.

However, this doesn’t mean interactions can’t happen with Repatha. Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

If you take any other medications with Repatha, talk with your doctor or pharmacist. They can tell you if these medications may interact with Repatha.

It’s not known if Repatha is safe to use during pregnancy. There haven’t been enough clinical studies of the drug in human pregnancy to know for sure.

If you’re pregnant or planning to become pregnant, talk with your doctor before starting Repatha treatment. They’ll tell you about the risks and benefits of using Repatha while pregnant.

Doctors aren’t sure whether it’s safe to take Repatha during pregnancy. Talk with your doctor about your birth control needs with Repatha if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend if you should use birth control with this medication.

It’s not known if Repatha passes into breast milk. So, it isn’t known whether Repatha affects children who are breastfed.

If you’re breastfeeding or planning to breastfeed, talk with your doctor. They can suggest healthy ways to feed your child while you’re using Repatha.

Tell your doctor about your health history before starting treatment with Repatha. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

• Allergy to rubber or latex. Syringes and autoinjectors of Repatha contain a latex-like form of rubber. It may not be safe for you to use these forms of Repatha if you have a rubber or latex allergy. Before using Repatha, tell your doctor if you have this allergy. The cartridge form of Repatha does not contain rubber and may be safe for you to use. Or, your doctor can advise if a medication other than Repatha is better for you.
• Allergic reaction. Your doctor will likely not prescribe Repatha if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
• Pregnancy. It isn’t known if Repatha is safe to take while pregnant. If you’d like to learn more information about taking Repatha while pregnant, view the “Repatha: Using while pregnant” section above.
• Breastfeeding. It’s not known if Repatha passes into breast milk during breastfeeding. If you’d like to learn more information about taking Repatha while breastfeeding, view the “Repatha: Using while breastfeeding” section above.

To learn more about effects of Repatha that could be harmful, see the “Repatha: Side effects” section above.

For some drugs, taking more than the recommended dosage may lead to unwanted side effects or overdose. Do not use more Repatha than your doctor advises.

Call your doctor if you think you’ve taken too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. However, if your symptoms are severe, call 911 or your local emergency number. Or go to the nearest emergency room right away.

If you have questions about Repatha, talk with your doctor. They can help advise you on whether Repatha could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor.

• Should I take Repatha alone or in combination with other cholesterol-lowering drugs?
• How often should I have my cholesterol levels checked while taking Repatha?
• Does Repatha interact with any other medications I’m taking?

Your doctor may also tell you about other treatment options for your condition. You may find this article helpful in learning about alternative drugs for treating high cholesterol. And check out our selection of videos on cardiovascular health.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.