evolocumab (Subcutaneous route)
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antihyperlipidemic
Pharmacologic Class: PCSK9 Inhibitor
Uses For evolocumab
Evolocumab injection is used together with a proper diet and a statin medicine to treat patients with heterozygous familial hypercholesterolemia or atherosclerotic heart problems, who need additional lowering of LDL cholesterol. It is also used together with a proper diet and other medicine to treat patients with homozygous familial hypercholesterolemia (HoFH), who need additional lowering of LDL cholesterol. evolocumab is a PCSK9 (proprotein convertase subtilisin kexin type 9) inhibitor.
evolocumab is available only with your doctor's prescription.
Before Using evolocumab
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For evolocumab, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to evolocumab or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of evolocumab injection in the pediatric population. Safety and efficacy have not been established in children younger than 13 years of age with HoFH, and in children with primary hyperlipidemia.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of evolocumab injection in the elderly.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Proper Use of evolocumab
evolocumab is given as a shot under your skin, usually in the abdomen or stomach, thighs, or upper arms.
If you are using evolocumab at home, your doctor will teach you how to prepare and inject the medicine. Be sure that you understand exactly how the medicine is prepared and injected.
evolocumab comes in 3 forms: single-dose prefilled pen (autoinjector), single-dose prefilled syringe, and single-use Pushtronex™ system (on-body infusor with prefilled cartridge). Your doctor will prescribe the type and dose that is right for you.
You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems from the injections.
Do not inject on skin areas that have cuts, scrapes, infection, scars, or stretch marks.
If you are receiving the 420 mg dose of Repatha®, it can be given by: over 9 minutes by using the single-use Pushtronex™ system, or by 3 injections consecutively within 30 minutes using the single use prefilled syringe or autoinjector.
The autoinjector pen or prefilled syringe should be removed from the refrigerator and allowed to reach room temperature for at least 30 minutes prior to injection, or for at least 45 minutes for single-use Pushtronex™ system. Do not shake the medicine.
Use each autoinjector pen or syringe only one time. Do not save an open pen or syringe. If the medicine in the pen or syringe has changed color, or if you see particles in it, do not use it.
In addition to evolocumab, your doctor may change your diet to one that is low in fat, sugar, and cholesterol. Carefully follow your doctor's order about any special diet.
evolocumab should come with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
The dose of evolocumab will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of evolocumab. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For injection dosage form:
- For primary hyperlipidemia:
- Adults—140 milligrams (mg) injected under your skin every 2 weeks, or 420 mg injected under your skin once a month.
- Children—Use and dose must be determined by your doctor.
- For homozygous familial hypercholesterolemia:
- Adults and children 13 years of age and older—420 milligrams (mg) injected under your skin once a month.
- Children younger than 13 years of age—Use and dose must be determined by your doctor.
- For primary hyperlipidemia:
evolocumab needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.
If you missed a dose, use evolocumab within 7 days from the missed dose. Then, resume your original schedule.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store in the refrigerator. Do not freeze.
You may also keep the medicine in the original carton at room temperature for 30 days. Throw away any unused medicine within 30 days.
Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
Precautions While Using evolocumab
It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly to lower your cholesterol levels and to decide if you should continue to use it. Blood tests may be needed to check for unwanted effects.
Serious allergic reactions may occur while you are using evolocumab. Tell your doctor right away if you have the following symptoms: a rash, itching skin, difficulty with breathing or swallowing, hives, nausea, reddening of the skin, especially around the ears, swelling of the eyes, face, or inside of the nose, or unusual tiredness or weakness.
The needle cover of the prefilled syringe or autoinjector contains dry natural rubber (a derivative of latex), which may cause allergic reactions in people who are sensitive to latex. The single use Pushtronex™ system is not made with natural rubber latex. Tell your doctor if you have a latex allergy before you start using evolocumab.
evolocumab Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:Incidence not known
- Difficulty with breathing or swallowing
- hives, itching, or rash
- reddening of the skin, especially around the ears
- swelling of the eyes, face, or inside of the nose
- unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Back pain
- bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
- body aches or pain
- ear congestion
- loss of voice
- muscle aches
- sore throat
- stuffy or runny nose
- Abdominal or stomach pain
- bladder pain
- bloody or cloudy urine
- blurred vision
- difficult, burning, or painful urination
- difficulty with moving
- frequent urge to urinate
- loss of appetite
- lower back or side pain
- muscle aching or cramping
- muscle or joint pain
- muscle stiffness
- pain or tenderness around the eyes and cheekbones
- pounding in the ears
- slow or fast heartbeat
- swollen joints
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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