Repatha (evolocumab)

What is Repatha?

Repatha is a brand-name prescription medication. It’s FDA-approved to:

• Decrease low-density lipoprotein (LDL) cholesterol in adults with primary hyperlipidemia (high cholesterol). For this purpose, Repatha is used with a healthy diet and may be used with other LDL-lowering drugs or on its own.
• Decrease LDL cholesterol in adults and children ages 10 years and older with a type of primary hyperlipidemia called heterozygous familial hypercholesterolemia (HeFH). For this purpose, Repatha is used with a healthy diet and may be used with other LDL-lowering drugs or on its own.
• Decrease LDL cholesterol in adults and children ages 10 years and older with a genetic condition called homozygous familial hypercholesterolemia (HoFH). For this purpose, Repatha is used along with a healthy diet and may be used with other LDL-lowering drugs.
• Reduce the risk of heart attack or stroke, and reduce the need for certain types of heart surgery, in adults with heart disease.

For more information about how the drug is used, see the “Repatha uses” section below.

Drug details

Repatha belongs to a class of medications called PCSK9 inhibitors. These drugs help your body remove LDL (“bad”) cholesterol more effectively than it could on its own. They work differently than other drugs used for high cholesterol, such as statins, and have different side effects as well. (For more information, see the “Repatha side effects” section below.)

Repatha comes as a liquid solution in three forms:

• Prefilled syringe.
• Prefilled SureClick autoinjector.
• Pushtronex system, which is a single-use, on-body infusor with prefilled cartridges. “On-body” means the infusor attaches to your body. It gives your Repatha injection over about 5 minutes.

Repatha is available in two strengths: 140 milligrams per milliliter (mg/mL) and 420 mg/3.5 mL. Your doctor will prescribe either a 140-mg or 420-mg dose of Repatha every 2 weeks or a 420-mg dose once every month.

Repatha is given by subcutaneous injection. You’ll use Repatha at home after your doctor teaches you or your caregiver on how to give the injections.

Effectiveness

For information on the effectiveness of Repatha, see the “Repatha uses” section below.

Repatha side effects

Repatha can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Repatha. 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 side effects that may be bothersome.

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 side effects

Mild side effects of Repatha can include:*

• bruising, pain, or discoloration at the injection site
• infections, such as influenza (flu) and urinary tract infection (UTI)
• high blood pressure
• pain in your back or muscles†
• upper respiratory infection, such as the common cold

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.

* This is a partial list of mild side effects from Repatha. To learn about other mild side effects, talk with your doctor or pharmacist, or view Repatha’s prescribing information.
† For more information on this side effect, see “Side effect details” below.

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:

• high blood sugar, which could lead to diabetes*
• allergic reaction*

* For more information about this side effect, see “Side effect details” below.

How long do side effects of Repatha last?

It isn’t known exactly how long side effects from Repatha may last. This could vary from person to person. The drug can stay in your body for about 55 to 85 days. It’s possible you could experience side effects even after you stop taking the drug as your body continues to get rid of it.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on certain side effects this drug may or may not cause.

For additional details about Repatha’s side effects, see this article.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Repatha. Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

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
• swelling of your tongue, mouth, or throat
• trouble breathing

It’s not known how often allergic reactions occurred in people taking Repatha in clinical trials.

However, severe allergic reactions have occurred in some people using this medication. Call your doctor right away if you have a severe allergic reaction to Repatha. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Needle covers on Repatha prefilled syringes and prefilled SureClick autoinjectors contain a substance similar to latex. If you’re allergic to latex, you may have an allergic reaction if you use these forms of the drug. Be sure to tell your doctor about any allergies you have.

Diabetes

It’s possible that Repatha could raise blood sugar levels enough to lead to diabetes. In one large clinical trial of Repatha, researchers looked at 27,525 people with heart disease. Some of the people didn’t have diabetes when the study began.

From the group that didn’t have diabetes at the start of the study:

• 8.1% of people who took Repatha developed diabetes
• 7.7% of people who took a placebo (treatment with no active drug) developed diabetes

Symptoms of diabetes can include fatigue, feeling thirstier than usual, dry mouth, and needing to urinate more often than usual.

If you experience symptoms of diabetes, talk with your doctor.

Muscle pain

Some people may experience muscle pain while taking Repatha. In one study, people with heart disease received either Repatha or a placebo (a treatment with no active drug). Everyone also received a statin drug. The results showed that:

• 5% of people who took Repatha plus a statin drug had a muscle-related side effect
• 4.8% of people who took a placebo plus a statin drug had a muscle-related side effect

Muscle pain is also a possible side effect of statin drugs. Repatha is sometimes used with a statin for treating high cholesterol that can’t be lowered with a statin alone.

If you experience muscle pain while taking Repatha, talk with your doctor. They may have you try a different medication to treat your condition.

Weight loss

Weight loss wasn’t a side effect reported in clinical trials of Repatha. However, weight loss can be caused by gastroenteritis, which was a side effect seen in clinical trials of Repatha.

Gastroenteritis is swelling in your stomach and intestines that can cause diarrhea and abdominal cramps.

In clinical trials:

• 3% to 6.1% of people who took Repatha had gastroenteritis, depending on the condition treated
• 0% to 2% of people who took a placebo had gastroenteritis, depending on the condition treated

If you experience unexpected weight loss while taking Repatha, talk with your doctor.

Hair loss (not a side effect)

Hair loss isn’t a known side effect of Repatha. It wasn’t reported in clinical trials of the drug.

Repatha generic or biosimilar

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

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.

Repatha cost

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.

For further information, refer to this detailed article.

Coupons for Repatha

Visit this page to access Optum Perks coupons and get price estimates for Repatha when you use the coupons. These coupons can provide significant savings on your prescription costs.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Financial and insurance assistance

If you need financial support to pay for Repatha, or if you need help understanding your insurance coverage, help is available.

Amgen, the manufacturer of Repatha, offers the RepathaReady program. This program includes access to the Repatha Copay Card, which may help lower the cost of the drug for you. For more information and to find out if you’re eligible for support, call 844-REPATHA (844-737-2842) or visit the manufacturer’s website.

Biosimilar version

Repatha is available only as a brand-name prescription 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 generic drug, by contrast, is an exact copy of a brand-name drug that’s made from chemicals.

A biosimilar drug is a bit like a generic version of a biologic drug. It’s a very similar version of the parent biologic drug, but it’s not identical. Biosimilar drugs are made to treat the same conditions as the parent drug. They’re considered to be as safe and effective as the parent drug.

Repatha dosage

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 strengths

Repatha comes as a liquid solution in three forms:

• Prefilled syringe.
• Prefilled SureClick autoinjector.
• Pushtronex system, which is a single-use, on-body infusor with prefilled cartridges. “On-body” means the infusor attaches to your body. It gives your Repatha injection over about 5 minutes.

Each of the three forms of Repatha contains a colorless or pale yellow liquid solution, which is given by subcutaneous injection.

Repatha is available in two strengths: 140 milligrams per milliliter (mg/mL) and 420 mg/3.5 mL. The 420 mg/3.5 mL strength is only available in the cartridges used with the Pushtronex system.

You’ll use Repatha at home after your doctor trains you or your caregiver on how to give the injections. If you take other injectable drugs, you shouldn’t inject those drugs into the same area where you inject Repatha.

See the “How to inject Repatha” section below for information about using this drug.

Dosage for decreasing LDL cholesterol in adults with primary hyperlipidemia

Repatha is approved to decrease low-density lipoprotein (LDL) cholesterol in adults with primary hyperlipidemia (high cholesterol), including those with heterozygous familial hypercholesterolemia (HeFH).

For treating primary hyperlipidemia, the recommended dose of Repatha for adults is either:

• 140 mg given by subcutaneous injection every 2 weeks
• 420 mg given by subcutaneous injection once every month

If your doctor prescribes the 140-mg dose, you’ll use either a prefilled syringe or the prefilled SureClick autoinjector for your dose.

If your doctor prescribes the 420-mg dose, you can use the Pushtronex system to inject a prefilled cartridge over 5 minutes. Or you can use the SureClick autoinjector or prefilled syringe to give three consecutive injections within 30 minutes.

Dosage for decreasing LDL cholesterol in children with HeFH

For lowering LDL cholesterol in children ages 10 years and older with heterozygous familial hypercholesterolemia (HeFH), the recommended Repatha dosage is either:

• 140 mg given by subcutaneous injection every 2 weeks
• 420 mg given by subcutaneous injection once every month

If your child’s doctor prescribes the 140-mg dose, you’ll use either a prefilled syringe or the prefilled SureClick autoinjector.

If your child’s doctor prescribes the 420-mg dose, you can use the Pushtronex system to inject a prefilled cartridge over 5 minutes. Or you can use the SureClick autoinjector or prefilled syringe to give three consecutive injections within 30 minutes.

Dosage for decreasing LDL cholesterol in adults and children with HoFH

For lowering LDL cholesterol in adults and children ages 10 years and older with homozygous familial hypercholesterolemia (HoFH), the recommended Repatha dosage is 420 mg given by subcutaneous injection once a month.

After 12 weeks of treatment, your doctor may increase your dosage if the starting dosage isn’t working well enough. In this case, they’d increase your dosage to 420 mg given every 2 weeks. Doctors may also prescribe this dosage to people using lipid apheresis therapy. (This is a blood filtration therapy that’s used to lower cholesterol.)

There are two options for receiving your dose:

• using the Pushtronex system to inject a prefilled cartridge over 5 minutes
• using the SureClick autoinjector or prefilled syringe to give three consecutive injections within 30 minutes

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

Repatha is approved to lower the risk of heart attack or stroke, and to reduce the need for certain heart surgeries in adults with heart disease.

For these purposes, the recommended dose of Repatha is either:

• 140 mg by subcutaneous injection every 2 weeks
• 420 mg by subcutaneous injection once a month

If your doctor prescribes the 140-mg dose, you’ll use either a prefilled syringe or the prefilled SureClick autoinjector for your dose.

If your doctor prescribes the 420-mg dose, you can use the Pushtronex system to inject a prefilled cartridge over 5 minutes. Or you can use the SureClick autoinjector or prefilled syringe to give three consecutive injections within 30 minutes.

Pediatric dosage

The recommended Repatha dose for lowering LDL cholesterol in children with heterozygous familial hypercholesterolemia (HeFH) is either:

• 140 mg given by subcutaneous injection every 2 weeks
• 420 mg given by subcutaneous injection once every month

The recommended Repatha dose for lowering LDL cholesterol in children with homozygous familial hypercholesterolemia (HoFH) is 420 mg by subcutaneous injection once a month.

After 12 weeks of treatment, your doctor may increase the dosage if the starting dosage isn’t working well enough. In this case, doctors may increase the dosage to 420 mg given every 2 weeks. Doctors may also prescribe this dosage to children using lipid apheresis therapy. (This is a blood filtration therapy that’s used to lower cholesterol.)

For information on how to administer these doses, see the sections above.

Dosage questions

Below are answers to some questions you may have about taking Repatha. You can also see this article for details about Repatha’s dosage.

What if I miss a dose?

If you miss your Repatha dose, take your dose within 7 days of the missed dose. Then go back to your original dosing schedule.

In some cases, you may not be able to take your missed dose within 7 days of the scheduled dose date. For example, this may happen if you’re traveling and accidentally leave the drug at home. What you should do depends on the Repatha dose your doctor prescribes.

If you’re taking Repatha every 2 weeks, you should skip the missed dose and wait to take your next Repatha dose as scheduled. If you’re taking Repatha once a month, go ahead and take your missed dose, even if it’s been more than 7 days. Then use that date to create your new dosing schedule.

If you’re unsure whether you should take your missed dose or not, call your doctor to check.

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.

Will I need to use this drug long term?

Repatha is meant to be used as a long-term treatment. If you and your doctor determine that Repatha is safe and effective for you, you’ll likely take it long term.

Alternatives to Repatha

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.

Alternatives for lowering LDL cholesterol in adults with primary hyperlipidemia

Examples of other drugs that may be used to lower low-density lipoprotein (LDL) cholesterol in adults with primary hyperlipidemia (high cholesterol) include:

• statin drugs,* such as:
  • atorvastatin (Lipitor)
  • fluvastatin (Lescol XL)
  • lovastatin (Altoprev)
  • pitavastatin (Livalo)
  • pravastatin
  • rosuvastatin (Crestor)
  • simvastatin (Zocor)
• bile acid binding resins, such as:
  • cholestyramine (Prevalite)
  • colesevelam (Welchol)
  • colestipol (Colestid)
• ezetimibe (Zetia)
• fibrates, such as:
  • fenofibrate (Antara, Lipofen, Tricor)
  • gemfibrozil (Lopid)
• other injectable medications, such as:
  • alirocumab (Praluent)

* Some of these drugs are also approved to reduce the risk of death from heart problems or stroke. For more information about your treatment options, talk with your doctor.

Alternatives for lowering LDL cholesterol in adults and children with HeFH or HoFH

Examples of other drugs that may be used to treat heterozygous familial hypercholesterolemia (HeFH) and homozygous familial hypercholesterolemia (HoFH) include:

• other injectable medications, such as
  • alirocumab (Praluent)
• bile acid sequestrants, such as:
  • cholestyramine (Prevalite)
  • colesevelam (Welchol)
  • colestipol (Colestid)
• statins, such as:
  • atorvastatin (Lipitor)
  • rosuvastatin (Crestor)
  • simvastatin (Zocor)

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

Other drugs are used to reduce the risk of heart attack or stroke, and to reduce the need for certain heart surgeries in adults with heart disease. Examples of these other drugs include:

• statin drugs, such as:
  • atorvastatin (Lipitor)
  • fluvastatin (Lescol XL)
  • lovastatin (Altoprev)
  • pitavastatin (Livalo)
  • pravastatin
  • rosuvastatin (Crestor)
  • simvastatin (Zocor)
• other injectable medications, such as:
  • alirocumab (Praluent)

Repatha vs. Praluent

You may wonder how Repatha compares with other medications that are prescribed for similar uses. Here we look at how Repatha and Praluent are alike and different.

For more information about how the two drugs compare, see this comprehensive article.

Ingredients

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

Praluent contains the active drug alirocumab, which is also a PCSK9 inhibitor.

Uses

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

• Both Repatha and Praluent are FDA-approved to:
  • Decrease low-density lipoprotein (LDL) cholesterol in adults with primary hyperlipidemia (high cholesterol), including those with heterozygous familial hypercholesterolemia (HeFH). For this purpose, both drugs are used with a healthy diet and may be used with other LDL-lowering treatments.
  • Decrease LDL cholesterol in adults with a genetic condition called homozygous familial hypercholesterolemia (HoFH). For this purpose, both drugs are used with other LDL-lowering treatments.
  • Reduce the risk of cardiovascular problems (such as heart attack and stroke) in adults.
• Repatha is also FDA-approved to:
  • Decrease LDL cholesterol in children ages 10 years and older with HoFH. For this purpose, Repatha is used with other LDL-lowering treatments.
  • Decrease LDL cholesterol in children ages 10 years and older with HeFH. For this purpose, it’s used with a healthy diet and other LDL-lowering treatments.

Drug forms and administration

Both Repatha and Praluent come as a liquid that’s given as a subcutaneous injection.

Repatha comes in three forms:

• prefilled syringe
• prefilled SureClick autoinjector
• Pushtronex system, which is a single-use, on-body infusor with prefilled cartridges

Praluent comes as a prefilled pen.

Side effects and risks

Repatha and Praluent have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Repatha and Praluent (when taken individually).

• Can occur with Repatha:
  • urinary tract infection (UTI)
  • pain in your back or muscles
• Can occur with Praluent:
  • few unique mild side effects
• Can occur with both Repatha and Praluent:
  • bruising, pain, or skin discoloration at the injection site
  • influenza (flu)
  • upper respiratory infection, such as the common cold

Serious side effects

These lists contain examples of serious side effects that can occur with each drug, or with both Repatha and Praluent (when taken individually):

• Can occur with Repatha:
  • high blood sugar
  • high blood pressure
• Can occur with Praluent:
  • no unique serious side effects
• Can occur with both Repatha and Praluent:
  • allergic reaction

Effectiveness

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

• lower LDL cholesterol in adults with primary hyperlipidemia (high cholesterol), when used with a healthy diet
• lower LDL cholesterol in adults with a genetic condition called homozygous familial hypercholesterolemia (HoFH)
• 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 Praluent to be effective for treating high cholesterol.

Costs

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

Repatha and Praluent are both biologic drugs that aren’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 generic drug, by contrast, is an exact copy of a brand-name drug that’s made from chemicals.

A biosimilar drug is a bit like a generic version of a biologic drug. It’s a very similar version of the parent biologic drug, but it’s not identical. Biosimilar drugs are made to treat the same conditions as the parent drug. They’re considered to be as safe and effective as the parent drug.

Repatha vs. Crestor

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:
  • treat primary hyperlipidemia (high cholesterol) in adults, when used with a healthy diet
  • treat high cholesterol caused by homozygous familial hypercholesterolemia (HoFH) in adults when used with a healthy diet
  • reduce the risk of cardiovascular problems (such as heart attack and stroke) in adults
• Repatha is also FDA-approved to treat:
  • heterozygous familial hypercholesterolemia (HeFH) in adults and children ages 10 years and older when used with a healthy 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’s given as a subcutaneous injection. It’s available in three forms:

• prefilled syringe
• prefilled SureClick autoinjector
• Pushtronex system, which is a single-use, on-body infusor with prefilled cartridges

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. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Repatha and Crestor (when taken individually).

• Can occur with Repatha:
  • bruising, pain, or skin discoloration at the injection site
  • infections, such as influenza (flu) and urinary tract infection (UTI)
  • pain in your back
  • protein or blood in the urine
  • upper respiratory infection, such as the common cold
• Can occur with Crestor:
  • fatigue
  • abdominal pain
  • constipation
  • headache
  • nausea
• Can occur with both Repatha and Crestor:
  • muscle pain

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).

• Can occur with Repatha:
  • high blood sugar
  • high blood pressure
• Can occur with Crestor:
  • liver problems
  • rhabdomyolysis (breakdown of muscles)
  • autoimmune myopathies (certain muscle conditions that affect muscular structure and function)
• Can occur with both Repatha and Crestor:
  • allergic reaction

Effectiveness

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

• treat primary hyperlipidemia (high cholesterol) in adults, when used with a healthy diet
• treat high cholesterol caused by homozygous familial hypercholesterolemia (HoFH) in adults and children, when used with a healthy 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 to be 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 both 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 version of 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.

Repatha uses

The Food and Drug Administration (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 primary hyperlipidemia

Repatha is FDA-approved 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, Repatha is used along with a healthy diet, as recommended by your doctor. Repatha can be used with other medications to treat your condition or used alone.

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 is effective for decreasing LDL cholesterol levels in adults with primary hyperlipidemia.

The adults first took a statin drug for 4 weeks before the study began. Then in the study 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). Each person continued taking the statin they were randomly assigned to take before 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%

In addition, after 12 weeks:

• 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:

• have coronary artery disease
• have previously had a heart attack
• have previously had a stroke or other cerebrovascular disease
• have peripheral vascular disease

Having high cholesterol raises your risk for complications from heart disease, like 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 was effective at reducing 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

People in the study were randomly chosen to get either Repatha or a placebo (a treatment with no active drug). They continued using other medications they were already taking. People who were assigned to get 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:

• heart attack
• stroke
• hospitalization for unstable angina
• procedures that help restore blood flow to the heart
• death from cardiovascular disease (heart and blood vessel disease)

The results below 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 received Repatha. This means if 100 people took Repatha for 1 year, between 4 and 5 people would experience 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 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 a condition called 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 cholesterol is cleared from your body. 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 along with the diet recommended by your doctor. In addition, your doctor may prescribe other LDL-lowering treatments, such as statin drugs, for use with Repatha.

Repatha is used in people with HoFH who’ve tried lowering their LDL cholesterol with diet and other treatments but still need help lowering 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 Repatha to be effective for lowering LDL cholesterol levels in adults and children with HoFH.

People in the study 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 treatments to lower cholesterol that 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 had their LDL levels lowered by 22%
• people who received the placebo had 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.

Common questions about Repatha

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 currently isn’t a 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 isn’t 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 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 below.

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 drugs that lower your cholesterol, 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 include other types of medications that lower cholesterol. 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 below. 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 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 PCSK9 inhibitors such as Repatha have 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 isn’t 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 cases of people taking Repatha developing kidney disease during treatment.

In addition, since Repatha was released onto the market, it hasn’t been reported to cause 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.

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 directly above.

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.

How Repatha works

Repatha is approved to do the following:

• Decrease low-density lipoprotein (LDL) cholesterol in adults with primary hyperlipidemia (high cholesterol). For this purpose, Repatha is used with a healthy diet and may be used with other LDL-lowering drugs or on its own.
• Decrease LDL cholesterol in adults and children ages 10 years and older with a type of primary hyperlipidemia called heterozygous familial hypercholesterolemia (HeFH). For this purpose, Repatha is used with a healthy diet and may be used with other LDL-lowering drugs or on its own.
• Decrease LDL cholesterol in adults and children ages 10 years and older with a genetic condition called homozygous familial hypercholesterolemia (HoFH). For this purpose, Repatha is used along with a healthy diet and may be used with other LDL-lowering drugs.
• Reduce the risk of heart attack or stroke, and reduce the need for certain types of heart surgery in adults with heart disease.

What happens with high cholesterol

Cholesterol is a fatty substance found in the cells of your body. It’s made in your liver. Cholesterol can also be found in foods such as eggs, cheese, and meat.

Cholesterol itself isn’t a harmful substance. Your body uses cholesterol to make some vitamins, hormones, and fluids that help you digest food.

High cholesterol occurs when you have more cholesterol in your blood than your body needs. This may be caused by genetics, smoking, not getting enough physical activity, or eating too many foods that are high in cholesterol. High cholesterol can raise your risk for heart disease.

What Repatha does

Repatha works by attaching to an enzyme (a protein that helps certain reactions happen in the body). This enzyme, called PCSK9, is found in your liver. Repatha blocks this enzyme from working, which helps your body remove cholesterol more effectively.

Repatha for heart disease

The FDA has approved Repatha 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:

• have coronary artery disease
• have previously had a heart attack
• have previously had a stroke or other cerebrovascular disease
• have peripheral vascular disease

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

How long does it take to work?

Repatha begins working as soon as you inject your dose. It takes about 4 hours after you take your dose for Repatha to start blocking the PCSK9 enzyme to its full ability.

However, you’re unlikely to notice the drug working in your body. This is because you can’t feel your cholesterol increasing or decreasing. Blood test results are the only way to tell if the drug is working.

How to inject Repatha

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

Repatha is given by subcutaneous injection either every 2 weeks or once per month. Repatha comes in three forms:

• Prefilled syringe.
• Prefilled SureClick autoinjector.
• Pushtronex system, which is a single-use, on-body infusor with prefilled cartridges. “On-body” means the infusor attaches to your body. It gives your Repatha injection over about 5 minutes.

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

What to do before your dose

Before using Repatha, take the drug out of the refrigerator and allow it to warm to room temperature (68°F to 77°F/20°C to 25°C). Repatha shouldn’t be warmed or heated by any other method. Warm the drug for the following times:

• If you’re using the prefilled syringe or the prefilled SureClick autoinjector, allow it to warm for at least 30 minutes before using it.
• If you’re using the prefilled cartridge with the Pushtronex system, it needs to warm at room temperature for at least 45 minutes.

Each form of Repatha contains a colorless or pale yellow liquid solution. Be sure to check for any discoloration or particles in your Repatha liquid before giving yourself an injection.

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 give 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. The injection site you use should be rotated for each injection. You’ll be able to use Repatha 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.

Repatha expiration, storage, and disposal

When you get Repatha from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about how to properly dispose of it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Repatha prefilled syringes should be refrigerated at a temperature of 36°F to 46°F (2°C to 8°C) in the original carton. This helps protect the syringes from light. You shouldn’t put Repatha in the freezer.

You may also keep Repatha at room temperature (68°F to 77°F/20°C to 25°C) in the original carton. However, if you store Repatha this way, it must be used within 30 days. Any part of the drug that isn’t used within 30 days should be thrown away.

Disposal

Right after you’ve used a syringe, needle, or autoinjector, dispose of it in an FDA-approved sharps disposal container. This helps prevent others, including children and pets, from taking the drug by accident or harming themselves with the needle. You can buy a sharps container online, or ask your doctor, pharmacist, or health insurance company where to get one.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Repatha use with other drugs

Depending on the condition it’s being used to treat, Repatha may be used 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).

For adults, it may be used alone or with other drugs that lower your cholesterol. For children, Repatha is typically used 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 to reduce the need for certain heart surgeries in adults with heart disease. For this purpose, Repatha doesn’t have to be used 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 interactions

Repatha isn’t known to interact with other medications. And it’s not known to interact with supplements or foods.

However, you should still talk with your doctor or pharmacist about possible interactions before taking Repatha. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid any potential interactions.

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

Repatha and pregnancy

It’s not known whether Repatha is safe to use while pregnant. This drug hasn’t been studied during pregnancy. The drug didn’t appear to cause harm when studied in pregnant monkeys, but animal studies don’t always predict what will happen in people.

If you’re pregnant or planning a pregnancy, talk with your doctor about the risks and benefits of taking Repatha.

Repatha and birth control

It’s not known if Repatha is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Repatha.

For more information about taking Repatha during pregnancy, see the “Repatha and pregnancy” section above.

Repatha and breastfeeding

It isn’t known if Repatha is safe to use while breastfeeding. This is because it’s not known if the drug passes into breast milk or the effect it could have on a child who is breastfed. In addition, no clinical trials of Repatha have involved lactating people or animals.

If you’re currently breastfeeding or planning to breastfeed, talk with your doctor about the risks and benefits of using Repatha.

Repatha precautions

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 not be able to use certain forms of Repatha. The needle covers used on Repatha prefilled syringes and the caps for the SureClick autoinjectors contain rubber. However, the Repatha single-use Pushtronex system is not made with natural rubber latex. Therefore, you may be able to use this form of the drug. Before taking Repatha, 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 shouldn’t take Repatha. Ask your doctor what other medications may be better options for you.
• Pregnancy. It isn’t known if Repatha is safe to use during pregnancy. For more information, see the “Repatha and pregnancy” section above.
• Breastfeeding. It isn’t known if it’s safe to use Repatha while breastfeeding. For more information, see the “Repatha and breastfeeding” section above.

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

Repatha overdose

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.