Repatha (evolocumab) is a prescription drug that’s used in certain situations to decrease serious heart-related risks and lower cholesterol. Repatha comes as a liquid solution for injection under your skin.

Doctors prescribe Repatha to:

For some uses, doctors may prescribe Repatha together with a low fat diet and other medications. To learn more, see the “What is Repatha used for?” section below.

Repatha basics

Repatha contains the active ingredient evolocumab. (An active ingredient is what makes a drug work.) It’s a biologic medication. Biologics are made from parts of living organisms.

Repatha isn’t available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.)

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Like most drugs, Repatha may cause mild or serious side effects. The lists below describe some of the more common side effects that Repatha may cause. These lists do not include all possible side effects.

How long Repatha’s side effects last may depend on which side effects you’re having. And it may differ for each person. Talk with your doctor about how long you should expect the drug’s side effects to last.

Keep in mind, side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Repatha’s side effects might also differ slightly depending on the condition you’re taking it to treat.

To learn more about Repatha’s side effects, see this article. Your doctor or pharmacist can also tell you more about the potential side effects of Repatha. And they can suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Repatha can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Repatha’s prescribing information.

Mild side effects of Repatha that have been reported include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information about this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Repatha can occur, but they aren’t common. If you have serious side effects from Repatha, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Repatha that have been reported include:

* For more information about this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects Repatha may cause.

Increased blood sugar levels, which may lead to diabetes

You may develop high blood sugar levels from taking Repatha. And this could lead to diabetes.

Increased blood sugar levels were one of the most common side effects in people taking Repatha during studies.

Most people in these studies also took Repatha with a statin drug such as atorvastatin (Lipitor). According to the Food and Drug Administration (FDA), statins may increase the risk of developing diabetes. This is especially the case with long-term use of statins.

Symptoms of a high blood sugar level can include:

What might help

If you already have high blood sugar levels or diabetes, be sure to tell your doctor before starting Repatha. Also, tell them if you’re currently taking a statin.

You may want to watch for symptoms of high blood sugar while you’re taking Repatha. Tell your doctor if you develop any of these symptoms during treatment.

Also, your doctor may recommend that you check your blood sugar level to see whether it’s high during Repatha treatment. Or they may check the level for you at your appointments.

If you have any questions or concerns about your blood sugar levels while you’re taking Repatha, talk with your doctor.

Muscle pain

You may experience muscle pain with Repatha, though this side effect of the drug wasn’t common during studies.

Muscle pain is a common side effect of statin drugs. Like Repatha, statins are used for cholesterol treatment. But Repatha is not a statin.

What might help

If you’re having muscle pain during treatment with Repatha, talk with your doctor. They may be able to determine what’s causing your pain. And they can recommend the best way to treat it.

Allergic reaction

Some people may have an allergic reaction to Repatha.

Symptoms of a mild allergic reaction can include:

  • skin rash or hives
  • eczema (a condition that causes patches of itchy or inflamed skin)
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

If you have an allergy to latex, tell your doctor before starting Repatha. They may not prescribe certain forms of the drug that could cause an allergic reaction.

Call your doctor right away if you have an allergic reaction to Repatha. But if you think you’re having a medical emergency, call 911 or your local emergency number.

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Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

Repatha financial support or coupon

If you have questions about how to pay for your prescription or ways to lower its cost, talk with your doctor or pharmacist. You can also visit the Repatha manufacturer’s website for support options. For example, the drug’s manufacturer provides a card that can help reduce the drug’s copay cost.

There isn’t a manufacturer coupon available, but see below for Optum Perks* coupon options in your area. You can also visit Optum Perks to get price estimates of what you’d pay for Repatha when using coupons from the site.

* Optum Perks is a sister site of Healthline. Optum Perks coupons cannot be used with any insurance copays or benefits.

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Retail price refers to the manufacturer’s published list price and is up to date as of 3/2023. Retail and discounted prices are U.S.-only and can vary based on region and pharmacy. We cannot guarantee that the discounted price listed here will exactly match the price at your pharmacy. Please contact your pharmacy for the exact price.

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Your doctor will recommend the dosage of Repatha that’s right for you. Below are commonly used dosages, but always administer the dosage your doctor prescribes.

Forms and strengths

Repatha comes as a solution for injection under your skin.

It’s available as prefilled, single-dose:

  • syringes
  • SureClick autoinjectors, which deliver doses over 15 seconds
  • Pushtronex systems, which deliver doses over 5 minutes

For more details about these three options for Repatha, check out the manufacturer’s webpage.

Repatha prefilled syringes and SureClick autoinjectors come in one strength: 140 milligrams per milliliter (mg/mL). Single-dose Pushtronex systems also come in one strength: 420 mg/3.5 mL.

Recommended dosages

How often you’ll administer Repatha and what dose you’ll take depends on the condition you’re using Repatha to treat. Below is an overview of Repatha’s typical dosages. To learn more, see this article. You can also talk with your doctor about the dosing schedule that’s best for you.

Dosage for decreasing serious heart-related risks

Doctors prescribe Repatha to help decrease risk of heart attack or stroke and decrease the need for heart surgery in adults who have heart disease. For this use, the typical dosage is either:

  • a 140-mg injection every 2 weeks, or
  • a 420-mg injection every month

Dosage for lowering cholesterol

For decreasing low-density lipoprotein (LDL) cholesterol in adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH), the typical dosage is either:

  • a 140-mg injection every 2 weeks, or
  • a 420-mg injection every month

This is also the dosage doctors usually prescribe to lower LDL cholesterol in children ages 10 years and over who have HeFH.

Doctors may also prescribe Repatha to decrease LDL cholesterol in adults and children ages 10 years and older who have homozygous familial hypercholesterolemia (HoFH). For this use, the typical starting dosage is a 420-mg injection every month. If this doesn’t work well enough to decrease LDL, doctors may increase the dosage to a 420-mg injection every 2 weeks.

Questions about Repatha’s dosage

Here are some common questions related to Repatha’s dosage.

What if I miss a dose of Repatha? If you miss a dose of Repatha, take it as soon as possible as long as it’s within 7 days of the missed dose. If it’s more than 7 days since your missed dose and you usually take a dose every 2 weeks, skip the missed dose. Then continue on with your normal schedule.

If it’s more than 7 days since your missed dose and you take a dose once every month, inject the dose as soon as you remember. Then begin a new dosing schedule each month from the date that you inject.

If you missed your dose and you don’t know when to take your next dose, talk with your doctor or pharmacist. They’ll be able to recommend the best time for you to take your next dose.

Will I need to use Repatha long term? How long should I take Repatha? Repatha is usually prescribed as a long-term treatment. If this medication is working for you, you’ll likely take it long term. Your doctor may recommend that you stop taking Repatha if it no longer works or if you have serious side effects from it.

How long does Repatha take to work? Repatha will begin working as soon as you take your first dose. In studies, the drug lowered certain cholesterol levels in some people within 4 to 12 weeks. Keep in mind you may not notice any difference in the way that you feel after starting Repatha. But it’s still important to continue taking the drug, even if you don’t feel its effect.

Repatha and Leqvio are both prescribed to lower cholesterol levels. Specifically, they both help decrease low-density lipoprotein (LDL) cholesterol in adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH). Repatha may also be used to lower LDL cholesterol in children ages 10 years and older who have HeFH.

Repatha has other uses as well. For more information, see the “What is Repatha used for?” section below.

You receive both these drugs as an injection under your skin, although they have different dosages.

Side effects of Repatha and Leqvio also vary. To see lists of possible side effects of Repatha, view the “What are Repatha’s side effects?” section above. And to learn about Leqvio’s side effects, view its prescribing information.

Your doctor can recommend whether either drug is right for your condition.

Repatha and Praluent have similar uses. They’re both prescribed to lower cholesterol levels in adults with certain conditions. (Some children may receive Repatha for this purpose.) They also both reduce the risk of heart attack or stroke in people with heart disease.

You receive these drugs as an injection under your skin. But they have some differences, including their dosages and side effects.

View this article to see a detailed comparison of Repatha and Praluent. You can also check with your doctor to see which drug is right for you.

Repatha vs. statins

Repatha and statin drugs both work to reduce cholesterol levels. But they work in different ways. This means they may have different doses and side effects, too.

To learn more about how Repatha differs from statins, check out this article. You can also ask your doctor for more information.

Find answers to some commonly asked questions about Repatha.

How does Repatha work? What’s its half-life?

Repatha’s mechanism of action (how it works) is to attach itself to a protein in your body called PCSK9.

This protein stops your body from getting rid of low-density lipoprotein (LDL) cholesterol. By blocking PCSK9, Repatha allows your body to get rid of LDL cholesterol more efficiently. This decreases your LDL level.

The half-life of Repatha is between 11 and 17 days. A drug’s half-life is the time it takes your body to clear half of a dose of the drug.

If you have more questions about how this drug works, talk with your doctor. Or check out this video from Repatha’s manufacturer.

Is Repatha a statin? Does it treat high triglycerides?

No, Repatha isn’t a statin. Instead, it belongs to a group of drugs called PCSK9 inhibitors. And it works differently than statins do.

Repatha isn’t approved to treat high triglycerides. Rather, it’s approved to lower a type of cholesterol called low-density lipoprotein (LDL) in certain people. It’s also approved to decrease the risk of heart attack or stroke and decrease the need for heart surgery in certain people. To learn more about Repatha’s uses, see the “What is Repatha used for?” section below.

If you have more questions about Repatha or the conditions it treats, talk with your doctor.

Who makes Repatha? Does the maker offer any reviews on its drug?

Repatha is made by a pharmaceutical company called Amgen. This company offers patient stories on its website from people who’ve taken Repatha.

You can read through these stories to see whether Repatha may be a fit for you. And be sure to talk with your doctor about whether this drug is a good option for your condition.

Does Repatha cause weight loss, hair loss, or pancreatitis?

Repatha isn’t known to cause weight loss, hair loss, or pancreatitis (inflammation of the pancreas). These weren’t reported as side effects in studies of the drug.

Your doctor may prescribe Repatha together with other drugs to treat high cholesterol. It’s possible that the other medications may cause these side effects.

If you have weight loss, hair loss, or pancreatitis while you’re taking Repatha, talk with your doctor. They may be able to find out what’s causing it and recommend treatment if needed.

Will Repatha cause liver or kidney problems? Does it lead to increased liver enzyme levels?

No, Repatha isn’t known to cause liver or kidney problems. But it isn’t clear whether liver enzyme levels were monitored in studies of people who took the drug.

A 2014 study and a 2020 study showed that PCSK9 inhibitors such as Repatha caused slightly increased liver enzyme levels. But these studies did not report liver problems in people taking the drug.

Keep in mind that other medications used for cholesterol treatment may cause liver or kidney problems. This includes statin drugs. But Repatha isn’t a statin.

Your doctor may recommend that you take Repatha together with a statin to treat your cholesterol. In this case, they may monitor your kidney and liver function.

If you have concerns about possible liver or kidney problems with Repatha, talk with your doctor.

How should I store Repatha? Does it need to be refrigerated?

You should store Repatha in the refrigerator, at a temperature between 36°F and 46°F (2°C and 8°C).

You can also store Repatha at room temperature, between 68°F and 77°F (20°C and 25°C). But you can only do this for up to 30 days. If you don’t use doses stored at room temperature within 30 days, you should throw the doses away.

You should also protect Repatha from light. And you should never freeze or shake Repatha.

If you have more questions about storing Repatha, ask your doctor or pharmacist.

If you have heart disease, your doctor may recommend Repatha. It helps decrease your risk of heart attack or stroke and decrease the need for heart surgery. For this use, Repatha is prescribed for adults who have heart disease.

If you have high cholesterol, your doctor may also recommend Repatha. It’s used to reduce low-density lipoprotein (LDL) cholesterol levels in people with certain types of high cholesterol. Your doctor may prescribe Repatha along with certain dietary changes or other cholesterol medications to treat this condition.

Specifically, doctors prescribe Repatha to:

  • Decrease LDL cholesterol in adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH). For this purpose, Repatha is meant to be part of a treatment plan that includes a low fat diet. (Cholesterol is a type of fat in the blood.) You may use the drug alone or together with other cholesterol medications.
  • Decrease LDL cholesterol in children ages 10 years and older who have HeFH. For this use, dooctors prescribe Repatha with a low fat diet and other cholesterol medications.
  • Decrease LDL cholesterol in adults and children ages 10 years and older who have homozygous familial hypercholesterolemia (HoFH). In this case, doctors prescribe the drug together with other cholesterol medications.

HeFH and HoFH are genetic conditions that cause high cholesterol.

Repatha works to decrease LDL cholesterol by attaching itself to a protein in your body, called PCSK9. Having high cholesterol increases your risk of heart attack, stroke, and other heart problems. Repatha helps lower your risk of these issues.

If you have more questions about how this drug works, see “How does Repatha work?” in the “What are some commonly asked questions about Repatha?” section above. Also, talk with your doctor or view this video from the drug’s manufacturer.

Before you start taking Repatha, talk with your doctor about your treatment plan. Be sure to discuss:

  • your overall health
  • any other medical conditions you have
  • any other medications you take

Your doctor will let you know whether Repatha is a safe and effective treatment option for you.

These considerations and others are described below.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before using Repatha, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Repatha.

For more about Repatha’s interactions, see this article.

Interactions with drugs or supplements

Repatha isn’t known to interact with other drugs or supplements. But it’s still important to tell your doctor about any other medications you’re taking. Be sure to do this before you start Repatha.

Warnings

Repatha may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Repatha. Factors to consider include allergic reaction, which is described below.

Allergic reaction

If you’ve had an allergic reaction to Repatha or any of its ingredients, you shouldn’t take Repatha.

If you have a latex allergy, you should not use the syringe or SureClick autoinjector. These forms of Repatha include latex. In this case, your doctor will likely prescribe Repatha’s Pushtronex system, which does not contain latex. (For more information about Repatha’s forms, see the “What is Repatha’s dosage?” section above.)

Repatha and alcohol

Repatha isn’t known to interact with alcohol. But if you’re taking a statin drug with Repatha and you drink alcohol, talk with your doctor about whether it is safe to do so.

Both alcohol and statins can affect your liver. So your doctor may recommend that you avoid drinking alcohol during treatment. Or they may recommend an amount of alcohol that’s safe for you.

Pregnancy and breastfeeding

It’s unknown whether Repatha is safe to take during pregnancy or while breastfeeding. If you’re pregnant or breastfeeding, talk with your doctor before using Repatha.

Your doctor will explain how you should take doses of Repatha. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Repatha

Repatha comes as a solution that you receive as an injection under your skin.

You’ll likely get your first dose of Repatha at your doctor’s office. In most cases, your doctor will show you or your caregiver how to inject the medication. This way, you can receive your doses at home.

You can view demonstration videos for injecting Repatha on the manufacturer’s webpage. To see detailed instructions on how to inject the drug based on form, check out the following:

To learn more about these options, see the “What is Repatha’s dosage?” section above.

Repatha injection sites

You can inject Repatha doses into your:

  • thigh
  • upper arm
  • abdomen, as long as you stay at least 2 inches away from your belly button

Never inject Repatha into an area that’s bruised, tender, or feels hard.

Taking Repatha with other drugs

In some cases, Repatha is used alone for high cholesterol. But in other cases, it’s used together with other cholesterol medications, such as statins.

For instance, doctors prescribe Repatha together with other cholesterol medications for homozygous familial hypercholesterolemia (HoFH). HoFH is a genetic condition that causes high cholesterol.

Examples of statins or other medications that your doctor may prescribe with Repatha include:

Talk with your doctor about the treatment plan that’s best for you. They can recommend whether you should take Repatha alone or together with other drugs.

Do not take more Repatha than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Repatha

Call your doctor if you think you’ve taken too much Repatha. You can also call 800-222-1222 to reach America’s Poison Centers, or use its online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

If you have heart disease, your doctor may recommend Repatha. They may also recommend Repatha if you have high cholesterol.

To learn more about the specific uses of Repatha, see the “What is Repatha used for?” section above.

If you have questions about taking Repatha or you wonder whether it’s an option for you, talk with your doctor or pharmacist. Here are some questions you may wish to ask:

  • What side effects might I have with Repatha based on my condition? And how can I treat them?
  • How long should I expect side effects from Repatha to last?
  • What should I do if I’m having trouble injecting doses of Repatha?
  • What should I do if I become pregnant while I’m taking Repatha?

If you’re just starting treatment for high cholesterol, you can refer to this article for tips on starting treatment. If you have this condition, you can also read about advances in treatment and certain treatment options.

To learn more about Repatha, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Q:

If I’m taking Repatha with another cholesterol-lowering drug, such as a statin, do I have an increased risk of side effects?

Anonymous

A:

It’s possible. Taking Repatha with a statin may increase the risk of certain side effects that can be caused by either drug. For example, both Repatha and statins may cause muscle pain.

But most people who took Repatha in studies also took statins or other cholesterol medications. And many of these people took the combination without severe side effects.

If you’re concerned about your risk of side effects with Repatha, talk with your doctor. Also, be sure to tell them about all of your current medications before starting Repatha.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Disclaimer: Healthline 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.