Key takeaways

  • Repatha is a brand-name medication used to lower LDL cholesterol in adults and children with certain genetic conditions. It is also prescribed to reduce the risk of heart attack, stroke, and the need for heart surgeries in adults with heart disease.
  • The drug is administered via an injection under the skin, and you can self-administer it at home after proper training. Repatha may be used alone or in combination with other cholesterol-lowering medications, such as statins, depending on the condition being treated.
  • While Repatha is generally considered safe, it’s important to discuss potential side effects and interactions with a doctor or pharmacist.

Repatha is a brand-name drug that comes as a liquid solution for injection under the skin. It’s prescribed for high cholesterol.

Repatha contains the active ingredient evolocumab and belongs to a class of drugs called PCSK9 inhibitors.

Specifically, the Food and Drug Administration (FDA) has approved Repatha, along with diet and exercise, to reduce low-density lipoprotein (LDL) cholesterol in:

Repatha is also approved for and prescribed to reduce the risk of the following cardiovascular (heart and blood vessel) events in adults at increased risk for these events:

Doctors may prescribe Repatha alone or with other cholesterol-lowering drugs. For more information about how Repatha is used, see the “Repatha uses” section.

Repatha is a biologic medication that’s available only as a brand-name prescription medication. It does not come in a biosimilar form.

A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug). Repatha is a biologic medication, which is also called a biologic.

A biologic drug is made from living cells, while other drugs are made from chemicals. Drugs made from chemicals can have generics, which are exact copies of the active drug in the brand-name medication.

Biologics, on the other hand, can’t be copied exactly. Therefore, instead of a generic, biologics have biosimilars. Biosimilars are “similar” to the parent drug, and they’re considered to be just as effective and safe.

Like generics, biosimilars are often less expensive compared with brand-name medications.

The Repatha dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Repatha to treat
  • your preference for the size of your Repatha dose
  • your preference for how often you want to receive your Repatha dose

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strength

Repatha is an injectable cholesterol medication that comes as a liquid solution in two forms: a prefilled syringe and a prefilled SureClick autoinjector.

Repatha is available in a strength of 140 milligrams per milliliter (mg/mL).

You will receive Repatha by subcutaneous injection. You will self-administer Repatha at home after a healthcare professional teaches you or your caregiver how to give the injections.

Repatha can cause mild or serious side effects. The following lists contain some of the key side effects that may occur during Repatha treatment. These lists don’t include all possible side effects.

For more information on the possible side effects of Repatha, talk with your doctor or pharmacist. They can give you tips on how to manage any bothersome side effects.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect with Repatha and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Mild side effects of Repatha can include:

This is only a partial list of mild side effects of Repatha. To learn about other mild side effects, see Repatha’s prescribing information.

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Repatha aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects can include allergic reaction.

The FDA approves prescription drugs such as Repatha to treat certain conditions. Repatha may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Repatha for decreasing LDL cholesterol in people with high cholesterol

Repatha is an injectable cholesterol drug designed to decrease low-density lipoprotein (LDL) cholesterol in adults with primary hyperlipidemia (high cholesterol).

For this purpose, Repatha can be used in adults with heterozygous familial hypercholesterolemia (HeFH). Repatha can also be prescribed for children ages 10 years and older with HeFH.

For treating primary hyperlipidemia, you will use Repatha along with a balanced, nutritious diet, as recommended by your doctor. It can also be used alone or with other medications to treat your condition.

LDL cholesterol is sometimes referred to as “bad cholesterol.” Repatha works to lower LDL cholesterol by helping your body get rid of LDL more effectively.

For more information about your condition, see our cholesterol hub.

Effectiveness for decreasing LDL cholesterol in adults with primary hyperlipidemia

A clinical trial has shown Repatha effectively decreases LDL cholesterol levels in adults with primary hyperlipidemia.

The adults first took a statin drug for 4 weeks before the study began. Once the study began, they were randomly assigned to take either 140 milligrams (mg) of Repatha every 2 weeks, 420 mg of Repatha once a month, or a placebo (a treatment with no active drug). They continued taking the assigned statin throughout the study. The researchers wanted to see how the treatments compared at lowering LDL cholesterol.

After 12 weeks:

  • people who received 140 mg of Repatha every 2 weeks with a statin had their LDL levels lowered by 63%
  • people who received a placebo every 2 weeks had their LDL levels increased by 8%
  • people who received 420 mg of Repatha once a month had their LDL levels reduced by 59%
  • people who received a placebo once a month had their LDL levels increased by 4%

Repatha for reducing the risk of heart attack, stroke, or the need for certain heart surgeries in adults with heart disease

Repatha is FDA approved to reduce the risk of heart attack or stroke and to reduce the need for certain heart surgeries in adults with heart disease. People who may take Repatha for this purpose include those who:

Having high cholesterol raises your risk for complications from heart disease, such as heart attack or stroke. By lowering your cholesterol levels, Repatha helps reduce your risk for complications from heart disease.

For more information about heart conditions, see our cardiovascular health hub.

Effectiveness for reducing the risk of heart attack or stroke and reducing the need for certain heart surgeries in adults with heart disease

In a clinical trial, Repatha effectively reduced the risk of heart attack or stroke in adults with heart disease. It was also effective at reducing the need for certain heart surgeries in adults with heart disease.

This study looked at adults who already had heart disease. Of these:

  • 81% had previously had a heart attack
  • 19% had previously had a nonhemorrhagic stroke (stroke not caused by a blood vessel in the brain breaking or leaking)
  • 13% had peripheral vascular disease

The study participants were randomly assigned to receive either Repatha or a placebo (a treatment with no active drug). They continued taking their other medications. The people assigned Repatha received either 140 mg every 2 weeks or 420 mg once a month.

The researchers compared the effectiveness of Repatha and a placebo by measuring the average time it took for a person in the study to experience any of the following:

The following results are reported in patient years. This shows how many people are expected to experience a result, depending on the number of people receiving treatment and their treatment length.

At the end of the study:

  • heart attack, stroke, death from cardiovascular disease, hospitalization for unstable angina, and certain types of heart surgery occurred at a rate of 4.5 per 100 patient years in people who received Repatha. This means if 100 people took Repatha for 1 year, between 4 and 5 people would experience a heart attack, stroke, or certain heart surgeries.
  • heart attack, stroke, death from cardiovascular disease, hospitalization for unstable angina, and certain types of heart surgery occurred at a rate of 5.2 per 100 patient years in people who received the placebo. This means if 100 people took Repatha for 1 year, about 5 people would experience a heart attack, stroke, or certain heart surgeries.

Repatha for lowering LDL cholesterol in adults and children with HoFH

Repatha is also FDA-approved to lower LDL (“bad”) cholesterol in people with homozygous familial hypercholesterolemia (HoFH). This drug can be prescribed for adults and children ages 10 years and older with this condition.

HoFH is a rare condition caused by a genetic mutation (an abnormal change in a gene) in the genes that control how your body clears cholesterol. The condition is called “homozygous” because the genes that cause it are inherited from both parents. People with HoFH have high levels of LDL cholesterol.

For treating HoFH, Repatha should be used alongside the diet recommended by your doctor. Your doctor may also prescribe other LDL-lowering treatments, such as statin drugs.

Repatha is used in people with HoFH who’ve tried lowering their LDL cholesterol with diet and other treatments but still need help reducing their cholesterol.

To learn more about heart conditions, visit our cardiovascular health hub.

Effectiveness for lowering LDL cholesterol in adults and children with HoFH

A 12-week clinical trial comparing Repatha with a placebo found that Repatha effectively lowered LDL cholesterol levels in adults and children with HoFH.

The study participants were randomly assigned to receive either 420 mg of Repatha or a placebo (a treatment with no active drug) once a month. They also continued taking any other cholesterol-lowering medications they were using before the study.

Researchers measured LDL levels before the study and again after 12 weeks. They found that:

  • people who received Repatha saw their LDL levels lowered by 22%
  • people who received the placebo saw their LDL levels increased by 9%

Repatha and children

Repatha is FDA approved for use in children ages 10 years and older with:

  • homozygous familial hypercholesterolemia (HoFH)
  • heterozygous familial hypercholesterolemia (HeFH), which is a type of primary hyperlipidemia

To learn more, see the sections directly above.

Repatha contains the active ingredient evolocumab, which belongs to a class of drugs called PCSK9 inhibitors.

Repatha is approved to reduce LDL cholesterol in certain adults and children and to lower the risk of heart attack or stroke and the need for certain types of heart surgery in adults with heart disease.

To learn how Repatha works to treat these conditions, see this how Repatha works article.

You should inject Repatha according to your doctor’s or healthcare professional’s instructions.

You will self-administer Repatha by subcutaneous injection either every 2 weeks or once per month. Repatha comes in two forms:

  • prefilled syringe
  • prefilled SureClick autoinjector

Your doctor or healthcare professional will teach you or your caregiver how to give Repatha injections at home. The drug manufacturer’s website also has step-by-step instructions for administering the Repatha injection.

What to do before your dose

Before injecting Repatha, take the drug out of the refrigerator and allow it to warm to room temperature (68°F to 77°F, or 20°C to 25°C). Allow it to warm for at least 30 minutes before administering it. You should not warm or heat Repatha using any other method.

Repatha is a colorless or pale yellow liquid solution. Before injecting yourself, check for discoloration or particles in the liquid.

If the solution looks discolored or has particles floating in it, do not use it. Instead, use a new Repatha dose. Then call 844-REPATHA (844-737-2842) to report this issue to the drug manufacturer.

When to use

You can administer your Repatha injection at any time of day.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

Where to inject Repatha

Injection sites for Repatha include the abdomen, upper arm,* or thigh. You should rotate the injection site you use for each injection. You will be able to administer Repatha injections at home after your doctor trains you or your caregiver on how to give the injections.

* If you want to inject Repatha into your upper arm, you’ll need someone else to give you the injection.

Depending on the condition you are receiving Repatha to treat, you may use it alone or with other medications.

Repatha can be used in adults with primary hyperlipidemia (high cholesterol). The drug can also be used in adults and children with heterozygous familial hypercholesterolemia (HeFH).

Adults may use Repatha alone or with other cholesterol-lowering drugs. Children typically receive Repatha with other cholesterol-lowering drugs. Examples of drugs that may be used with Repatha to treat high cholesterol include ezetimibe (Zetia) and statins, such as Lipitor or Crestor.

For treating homozygous familial hypercholesterolemia (HoFH) in adults and children, Repatha is used with other cholesterol drugs. This could include ezetimibe (Zetia) and statins such as Lipitor or Crestor.

Repatha is also used to reduce the risk of heart attack or stroke and the need for certain heart surgeries in adults with heart disease. For this purpose, you do not have to use Repatha with any specific medication. Your doctor will likely have you continue to take the drugs you use for other conditions, including heart disease.

If you have questions about using Repatha with other drugs, talk with your doctor or pharmacist.

Repatha is not known to interact with other medications, supplements, or foods.

However, this does not mean that interactions won’t be recognized in the future. For example, new drugs could be approved that interact with Repatha.

Before starting Repatha treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

Repatha and alcohol

There are no known interactions between Repatha and alcohol. However, excessive alcohol use can damage your liver over time. If you have a history of heavy alcohol intake and take Repatha with a statin drug, you may have a higher risk for side effects from the statin. For more information, see “Could Repatha affect my kidneys or liver?” in the “Common questions about Repatha” section.

If you drink alcohol, talk with your doctor about whether it’s safe for you to drink during your Repatha treatment. Also, if you have a history of heavy drinking or liver damage, tell your doctor before you begin taking Repatha with a statin drug.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

As with all medications, the cost of Repatha can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you may have to get Repatha at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively. Your insurance company may require you to use a specialty pharmacy to get Repatha.

Before approving coverage for Repatha, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Repatha, contact your insurance company.

Coupons for Repatha

You may be able to find drug coupons on prescription discount websites that can reduce the cost of your medication. These coupons cannot be used with insurance copays or benefits, but the discounted price may be lower than what you would pay through insurance.

Financial assistance

Amgen, the manufacturer of Repatha, offers the AmgenNow program that makes Repatha available directly to patients at a discounted monthly price. For more information and to find out if you’re eligible, visit the manufacturer’s website.

Also, some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:

Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Repatha, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

If you can become pregnant, are breastfeeding, or are using birth control, it’s important to consider whether Repatha is a safe choice for you.

You can refer to this Repatha reproductive health article for more information. If you have additional questions, talk with your doctor.

Repatha and Crestor are prescribed for similar uses. Here we look at how these drugs are alike and different.

Ingredients

Repatha contains the active drug evolocumab, which belongs to a class of medications known as PCSK9 inhibitors. Crestor contains the active drug rosuvastatin, which is a statin.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Repatha and Crestor to treat.

  • Both Repatha and Crestor are FDA-approved to:
  • Repatha is also FDA approved to treat:
    • heterozygous familial hypercholesterolemia (HeFH) in adults and children ages 10 years and older, alongside a balanced, nutritious diet, and may be used with other LDL-lowering treatments
    • HoFH in children ages 10 years and older, when used with other cholesterol-lowering treatments
  • Crestor is also FDA approved to treat:
    • atherosclerosis
    • high levels of triglycerides
    • primary dysbetalipoproteinemia (a genetic condition that causes high total cholesterol, high triglycerides, and low HDL levels)
    • mixed hyperlipidemia
    • HoFH in children ages 7 years and older
    • HeFH in children ages 8 years and older

Drug forms and administration

Repatha comes as a liquid that you inject subcutaneously. It’s available in a prefilled syringe or a prefilled SureClick autoinjector.

Crestor comes as a tablet that you take by mouth.

Side effects and risks

Repatha and Crestor have some similar side effects and others that vary. Examples of these side effects follow.

Mild side effects

These lists contain some of the most common mild side effects that can occur with each drug or with Repatha and Crestor when taken individually.

Serious side effects

These lists contain examples of serious side effects that can occur with Repatha, with Crestor, or with both drugs when taken individually.

Effectiveness

Repatha and Crestor have different FDA-approved uses, but they’re both used to:

  • treat primary hyperlipidemia (high cholesterol) in adults alongside a balanced, nutritious diet
  • treat high cholesterol caused by homozygous familial hypercholesterolemia (HoFH) in adults and children alongside a balanced, nutritious diet
  • reduce the risk of cardiovascular problems (such as heart attack and stroke) in adults

These drugs haven’t been directly compared in clinical trials. However, separate studies have found both Repatha and Crestor effective for the conditions they’re approved to treat.

Costs

The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Repatha and Crestor are brand-name drugs. Repatha is available only as a brand-name medication. It’s a biologic drug that isn’t currently available in generic or biosimilar form.

Biologic drugs are made using living cells. It’s not possible for drug companies to produce exact copies of these medications. A biosimilar is very similar to the parent biologic drug, but it’s not identical. Biosimilar drugs are made to treat the same conditions as the parent drug.

Crestor is available as a generic drug called rosuvastatin. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug.

Biosimilars and generics tend to cost less than brand-name drugs.

Praluent, like Repatha, is a PCSK9 inhibitor drug that comes in liquid form for injection under the skin. Both are biologic medications, and they are used for some of the same conditions. Read more about Repatha vs. Praluent.

Here are answers to some frequently asked questions about Repatha.

Will Repatha cure my condition?

No, Repatha won’t cure your condition. Repatha treats several types of high cholesterol. It also reduces the risk of heart attack, stroke, and the need for certain heart surgeries in adults with heart disease.

However, Repatha isn’t a cure. There is currently no known cure for any of the conditions that Repatha is approved to treat.

If you have questions about how Repatha works to treat your condition, talk with your doctor.

Is Repatha a statin?

No, Repatha is not a statin. Repatha belongs to a class of medications called PCSK9 inhibitors.

Statins lower cholesterol by preventing your liver from making new cholesterol. PCSK9 inhibitors, on the other hand, help your body get rid of cholesterol by blocking a certain protein in your liver that allows cholesterol to build up in your blood. For more information, see the “How Repatha works” section.

Your doctor may prescribe Repatha along with a statin drug. If you have questions about the differences between Repatha and statin drugs, talk with your doctor.

Does Repatha have to be used with a statin?

Whether you take Repatha with other drugs, including statins, depends on the condition you’re using Repatha to treat.

For treating primary hyperlipidemia (high cholesterol), including heterozygous familial hypercholesterolemia (HeFH), in adults, Repatha may be used alone. It may also be used with other cholesterol-lowering drugs, such as a statin. For children with HeFH, Repatha should be used with other cholesterol-lowering drugs.

For treating homozygous familial hypercholesterolemia (HoFH) in adults and children, Repatha should be used with other treatments for high cholesterol. This could include a statin, or it could be another type of cholesterol-lowering medication. It could also include treatments besides medications, such as LDL apheresis. (LDL apheresis uses a machine to filter LDL cholesterol out of your blood.)

Repatha and statins have some side effects in common. However, statins can also cause other side effects, including joint pain, pancreatitis, and rhabdomyolysis (a serious condition that breaks down muscle tissue).

To learn more about other drugs that may be used with Repatha, see the “Repatha use with other drugs” section. If you have questions about other treatments that may be used with Repatha, talk with your doctor.

Will Repatha reduce plaque in my arteries?

It’s possible that Repatha could reduce plaque (fatty deposits) in your arteries.

Repatha belongs to a class of medications known as PCSK9 inhibitors. These types of drugs are relatively new, and researchers are still learning about how they work and what conditions they may be able to treat.

In a 2016 study, Repatha used with a statin reduced artery plaque better than a placebo used with a statin. However, more research is needed to fully understand the effects of PCSK9 inhibitors, such as Repatha, on plaque in your arteries.

If you have questions about reducing plaque in your arteries, talk with your doctor.

Could Repatha affect my kidneys or liver?

Repatha is not known to affect your kidneys or liver. In clinical trials, people taking Repatha didn’t have liver side effects, including changes in their levels of liver enzymes. There were also no examples of people developing kidney disease during Repatha treatment.

In addition, since Repatha was released onto the market, there are no reports that it causes kidney or liver side effects.

However, kidney or liver side effects can occur with statin drugs. Your doctor may prescribe a statin for you to use with Repatha.

If you have questions about side effects of Repatha or other medications you may take with it, talk with your doctor or pharmacist. They can review your medications and determine if you have an increased risk for any side effects because of other drugs you’re taking.

Before taking Repatha, talk with your doctor about your health history. Repatha may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Latex or rubber allergy: If you have a latex or rubber allergy, you may be unable to use certain forms of Repatha. The needle covers used on Repatha prefilled syringes and the caps for the SureClick autoinjectors contain rubber. Before starting Repatha treatment, talk with your doctor about any allergies you may have.
  • Allergic reaction: If you’ve had an allergic reaction to Repatha or any of its ingredients, you should not use Repatha. Ask your doctor what other medications may be better options for you.
  • Pregnancy: It is unknown if Repatha is safe to use during pregnancy. For more information, see the “Things to consider when using Repatha” section.
  • Breastfeeding. It is unknown if it’s safe to use Repatha while breastfeeding. For more information, see the “Things to consider when using Repatha” section.

Note: For more information about the potential negative effects of Repatha, see the “Repatha side effects” section.

Do not use more Repatha than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Repatha

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Disclaimer: Medical News Today 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.

Repatha images

VIEW GALLERY2