Repatha’s Side Effects: What to Know

Repatha is a brand-name prescription drug. It’s a type of drug called a PCSK9 inhibitor, and it contains the active drug evolocumab.

This medication comes as a solution that’s given by subcutaneous injection. Repatha is available in prefilled syringes, SureClick autoinjectors, and cartridges for use with the Pushtronex system.

Repatha is approved by the Food and Drug Administration (FDA) to:

• lower the risk of stroke, heart attack, and the need for certain heart procedures in adults with heart disease
• lower the level of low-density lipoprotein (LDL) cholesterol in adults with either:
  • primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH)
  • homozygous familial hypercholesterolemia (HoFH)
• lower the level of LDL cholesterol in children ages 10 years and older with HeFH or HoFH

When Repatha is used to lower LDL cholesterol, doctors may prescribe it in combination with a low cholesterol diet or other LDL-lowering medications. Repatha is meant to be used as a long-term treatment.

Similar to other drugs, Repatha may cause adverse effects (side effects). Read below for information about possible side effects of Repatha injections, Repatha SureClick, and Repatha cartridges. This article describes common, mild, and serious side effects of the drug.

For a general overview of Repatha, including details about its uses, see this article. If you’d like to take Repatha, search here to find a healthcare professional who might prescribe it.

Some of Repatha’s side effects may be more common than others. These side effects may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about any side effects with Repatha.

Some of the more common side effects of Repatha that occurred during clinical studies are listed below. These side effects can vary depending on the condition Repatha is being used to treat.

More common side effects of Repatha in people with heart disease include:

• upper respiratory infection, such as a common cold
• changes in blood sugar level, which may lead to diabetes*

More common side effects of Repatha in people with high cholesterol include:

• back pain
• upper respiratory infection, such as a common cold or influenza (flu)
• injection site reaction*

* For more information about this side effect, see “Repatha: Side effects explained” below.

Repatha can cause mild side effects, which are listed below. However, this list doesn’t include all possible mild side effects. To learn more about Repatha’s side effects, view the drug’s prescribing information.

Repatha’s mild side effects include:

• back pain
• cough
• dizziness
• fatigue
• headache
• muscle pain or spasms
• nausea
• swelling of the stomach or intestines, which may lead to abdominal pain
• upper respiratory infection, such as a common cold or influenza (flu)
• urinary tract infection (UTI)
• injection site reaction*
• joint pain*
• diarrhea*

* For more information about this side effect, see “Repatha: Side effects explained” below.

The side effects listed above may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about side effects with Repatha.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Repatha and want to tell the FDA about it, visit MedWatch.

It’s possible to have serious side effects with Repatha. Serious side effects are listed below, but this list may not include all possibilities. To learn more about Repatha’s side effects, view the drug’s prescribing information.

Call your doctor right away if you have serious side effects with Repatha. However, if you think you’re having a medical emergency or life threatening side effects, call 911 or your local emergency number.

Serious side effects of Repatha and their possible symptoms include:

• High blood pressure, which doesn’t usually cause any symptoms unless it is severe. Symptoms of severe high blood pressure can include:
  • dizziness
  • headache
  • nosebleed
  • changes in speech or vision
• Changes in blood sugar level, which may lead to diabetes.*
• Allergic reaction.*†

* For more information about this side effect, see “Repatha: Side effects explained” below.
† An allergic reaction is possible after taking Repatha. However, it’s not clear whether this side effect occurred in clinical studies.

Here are some common questions about the drug’s side effects and answers to them. Talk with your doctor if you have other questions about this drug.

For most people, taking Repatha isn’t dangerous. In rare cases, the drug may cause serious side effects. However, most of its side effects are expected to be mild.

For more information about the drug’s side effects, see “Repatha: Mild side effects” and “Repatha: Serious side effects” above.

If you’re concerned about the risks of taking Repatha, talk with your doctor.

No, Repatha isn’t likely to cause hair loss. This wasn’t reported as a side effect in clinical studies of the drug.

Certain statin drugs, which are used to lower cholesterol, may cause hair loss. Repatha may sometimes be used in combination with statins to lower low-density lipoprotein (LDL) cholesterol. In this case, you may have hair loss while taking Repatha with these drugs. However, Repatha itself likely isn’t the cause.

If you have questions about hair loss and Repatha, talk with your doctor.

It’s not likely. Weight changes weren’t reported as side effects in clinical studies of Repatha.

However, Repatha may cause digestive problems such as nausea and diarrhea.* If these side effects are bothersome or long lasting, they may lead to loss of appetite that results in weight loss.

If you have weight loss or weight gain while taking Repatha, talk with your doctor. They can help determine what might be causing your weight change. Your doctor can also suggest ways to help you maintain a weight that’s healthy for you while you’re taking Repatha.

* For more information about this side effect, see “Repatha: Side effects explained” below.

Repatha isn’t known to cause liver problems, including liver damage. Liver-related side effects weren’t reported in clinical studies of the drug.

Keep in mind that certain other cholesterol-lowering drugs, such as statins, may cause liver problems. When Repatha is used to lower low-density lipoprotein (LDL) cholesterol, it may be taken in combination with these medications.

As a result, you may have liver problems because of the other cholesterol medications taken with Repatha. However, Repatha itself isn’t thought to cause liver problems.

If you have questions about liver problems and Repatha, talk with your doctor.

In rare cases, long-term side effects are possible with Repatha. Most of the drug’s side effects should go away with time. However, certain side effects of Repatha could lead to long-term problems.

For example, Repatha may cause changes in your blood sugar level, possibly leading to diabetes.* If left untreated, diabetes can cause damage to the eyes, heart, and kidneys. And this could cause long-term issues such as vision loss, heart disease, and kidney failure.  

If you’re concerned about possible long-term side effects with Repatha, talk with your doctor.

* For more information about this side effect, see “Repatha: Side effects explained” below.

Probably not. Memory loss wasn’t reported as a side effect in clinical studies of Repatha.

However, certain other cholesterol-lowering drugs are thought to cause memory loss. Statin drugs are an example. When Repatha is used to lower low-density lipoprotein (LDL) cholesterol, doctors may prescribe statins in combination with it.

So, it’s possible to have memory loss because of other cholesterol medications you’re taking with Repatha. However, Repatha itself is not thought to cause this side effect.

If you have questions about memory loss and Repatha, talk with your doctor.

Here’s detailed information about some of Repatha’s side effects.

Injection site reaction is possible with Repatha. This is a side effect that occurs around the area where Repatha is injected.

Injection site reaction was common in Repatha’s clinical studies. Examples of symptoms include:

• pain
• bruising
• redness or discoloration

To reduce your risk of an injection site reaction with Repatha, rotate your injection sites with each dose. Repatha can be injected into your thigh, upper arm, or abdomen. (For injections in your abdomen, you should avoid injecting the drug within 2 inches of your belly button.)

It’s also best to avoid injecting Repatha into hardened, discolored, tender, or bruised areas of skin. Additionally, avoid injecting it into areas of skin with stretch marks or scars. Injecting into these areas could make Repatha less effective in treating your condition.

If you have bothersome or severe injection site reactions with Repatha, talk with your doctor. They can suggest other ways to help ease your symptoms.

Changes in blood sugar levels may occur with Repatha. And high blood sugar levels could lead to diabetes.

Diabetes was one of the more common side effects reported in people during Repatha’s clinical studies. However, this doesn’t mean it will happen to you.

Symptoms of diabetes can include:

• increased thirst or hunger
• fatigue
• urinating more often than usual
• blurry vision
• dry mouth

If you have symptoms of diabetes while taking Repatha, talk with your doctor. They may order certain tests to check your blood sugar levels over time. Your doctor will advise on what you should do if you’re found to have diabetes.

Joint pain is a possible side effect of Repatha. However, it was less common in Repatha’s clinical studies.

Joint pain can also be a symptom of other side effects Repatha may cause, such as fatigue.

If you have joint pain while taking Repatha, talk with your doctor. They can suggest ways to ease your discomfort.

For example, your doctor may suggest that you take over-the-counter pain relievers such as Tylenol (acetaminophen) or Advil (ibuprofen). Be sure to talk with your doctor or pharmacist before taking any new medications. They’ll make sure it’s safe for you to take the medication with Repatha.

Diarrhea is possible with Repatha, although it was a less common side effect in the drug’s clinical studies.

In severe cases, diarrhea from Repatha can lead to:

• electrolyte imbalances
• dehydration

If you have diarrhea with Repatha, it’s important to stay hydrated. Drinking fluids such as Pedialyte or Gatorade can help keep you hydrated. Doing so can also help prevent or correct an existing electrolyte imbalance.

Tell your doctor if you have bothersome diarrhea while you’re taking Repatha. They may prescribe medications to help ease your symptoms.

Be sure to talk with your doctor about your health history before taking Repatha. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health.

The conditions and factors to consider include those described below.

Allergic reaction. If you’ve had an allergic reaction to Repatha or any of its ingredients, your doctor will likely not prescribe Repatha. Ask your doctor what other medications may be better options for you.

Rubber or latex allergy. Before using Repatha, tell your doctor if you have a rubber or latex allergy. The Repatha syringe and SureClick autoinjector contain a type of rubber that’s similar to latex. If you have an allergy to rubber or latex, these forms of Repatha may not be safe to use.

However, the Repatha Pushtronex system does not contain rubber, so it may be safe for you. Your doctor can recommend the form of Repatha that’s best for you. They can also advise if a medication other than Repatha is a better option.

There aren’t any known interactions between alcohol and Repatha. If you drink alcohol, ask your doctor about an amount that’s safe to drink while you’re taking Repatha.

It isn’t known if Repatha is safe to take while you’re pregnant or breastfeeding. There haven’t been enough human studies of the drug’s use in pregnant or breastfeeding people to know for certain.

If you’re pregnant, breastfeeding, or planning either, talk with your doctor before taking Repatha. They can advise on the risks and benefits of taking Repatha during these times.

Talk with your doctor or pharmacist to find out more information about Repatha. If you have questions about the drug’s side effects, your pharmacist or healthcare professional can help answer them for you.

In addition to discussing Repatha with your doctor, you may find the following articles helpful in learning more.

• Overview of Repatha. To read an overview of Repatha, see this article.
• Drug comparison. To learn how Repatha compares with Praluent, read this article. And to see a comparison with Crestor, see this article.
• Details about high cholesterol. To learn more about high cholesterol, which Repatha is used to treat, see this article.

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.