What is the difference between Leqvio and Repatha?

Q: What is the difference between Leqvio and Repatha?

Leqvio and Repatha are both injectable medicines that are used for the treatment of high cholesterol, by specifically lowering low density lipoprotein (LDL) levels. Although they both inhibit PCSK9 they work by different mechanisms. Repatha is a monoclonal antibody that binds directly to PCSK9 in the liver preventing it from binding to LDL receptors. Leqvio blocks the PCSK9 protein by interfering with the translation of PCSK9 messenger RNA. Both have the same result – and that is freeing up LDL receptors on the surface of liver cells which allows LDL cholesterol to be removed from the blood.

Medically reviewed by Carmen Pope, BPharm. Last updated on May 27, 2025.

Official Answer by Drugs.com

Both Leqvio and Repatha are injectable medicines used to lower low density lipoprotein (LDL) cholesterol levels (also referred to as "bad cholesterol"). While they target the same protein (PCSK9), they work differently to help your body manage cholesterol levels.

How They Work

Leqvio:

Stops PCSK9 production at its source
Blocks the instructions (mRNA) that create PCSK9
Given by healthcare providers twice yearly
Drug class: PCSK9 inhibitor (subclass: small interfering RNA [siRNA])

Repatha:

Directly blocks existing PCSK9
Works like a shield to protect cholesterol receptors
Self-injectable every 2-4 weeks
Drug class: PCSK9 inhibitor (subclass: human monoclonal antibody)

Who Can Use These Medications?

Leqvio is approved for:

Adults with high cholesterol caused by genetic reasons (primary hyperlipidemia) to lower LDL-C alongside statin therapy and dietary changes
Includes those with heterozygous familial hypercholesterolemia (HeFH).

Repatha can be used by:

People with established cardiovascular (CV) disease to reduce the risk of major adverse events such as a heart attack, stroke, unstable angina requiring hospitalization of CV death)
Adults and children 10+ with primary hyperlipidemia including HeFH to reduce LDL-C alongside diet, alone, or in combination with other LDL-C lowering treatments
Patients 10+ with homozygous familial hypercholesterolemia (HoFH) to reduce LDL-C alongside other LDL-C lowering treatments
People needing additional cholesterol management

Treatment Schedule

Leqvio:

First two doses 3 months apart
Then just twice per year
Must be given by healthcare provider

Repatha:

Given every 2-4 weeks
Can be self-administered at home
More frequent but flexible scheduling

Working with Other Treatments

Both medications:

Can be used with statins
Support lifestyle changes
Have no known drug interactions

Work best with:

Healthy diet
Regular exercise
Weight management
Smoking cessation

Key Facts: Leqvio Vs Repatha
	Levqio	Repatha
Generic name	Inclisiran	Evolocumab
Company	Novartis Pharmaceuticals Corporation	Amgen
FDA Approval date	Dec 2021	Aug 2015
Generic availability	None	None
Drug class	PCSK9 inhibitor (subclass: small interfering RNA [siRNA])	PCSK9 inhibitor (subclass: human monoclonal antibody)
Dosage form	Subcutaneous injection (administered by a healthcare professional)	Subcutaneous injection (self-administered)
Use	Reduces LDL cholesterol levels	Reduces LDL cholesterol levels
Indicated for	Primary hyperlipidemia including heterozygous familial hypercholesterolemia (HeFH)	Adults with established cardiovascular disease to lower the risk of heart attack or stroke Primary hyperlipidemia Heterozygous familial hypercholesterolemia (HeFH) in adults and children aged 10 and older Homozygous familial hypercholesterolemia (HoFH) in adults and adolescents aged 13 years or older
Dosing schedule and administration	Once every 6 months (2 doses per year)*	Once every 2 to 4 weeks
Common side effects	Injection site reactions (pain, swelling, or redness) Joint pain Diarrhea Urinary tract infections Bronchitis Pain in the legs and arms Shortness of breath	Injection site reactions Nasopharyngitis/sinusitis Upper respiratory tract infections Influenza Back pain and muscle pain Headache Dizziness High blood pressure Diarrhea Gastroenteritis
Warnings and precautions	No contraindications listed	Rarely, serious hypersensitivity reactions may occur; monitor for any signs of a rash or anaphylaxis and discontinue if noted
Approximate cost	$7,200 per year	$6,800 per year

*After an initial course of 2 injections, 3 months apart

What is the best time of day to take Repatha?

You can inject Repatha at any time of the day, but usually people prefer injecting Repatha during daylight hours because it takes 30 to 45 minutes for it to warm up to room temperature, and you need to be able to easily see what you are doing while you are injecting it. Continue reading

How long can Repatha be kept unrefrigerated?

Repatha can be left unrefrigerated for up to 30 days at room temperature between 68°F to 77°F (20°C to 25°C) as long as it is kept in its original box and is not kept somewhere that gets hotter than 77°F (25°C), for example, a car glove box. This makes it easier to take your medicine with you when you’re on the go. Do not put Repatha back in the refrigerator once you have taken it out. Continue reading

Can Repatha cause high blood pressure?

Repatha can cause high blood pressure (hypertension) as a side effect. Continue reading

What is the difference between Leqvio and Repatha?

How They Work

Leqvio:

Repatha:

Who Can Use These Medications?

Leqvio is approved for:

Repatha can be used by:

Treatment Schedule

Leqvio:

Repatha:

Working with Other Treatments

Both medications:

Work best with:

Related questions

Read next

What is the best time of day to take Repatha?

How long can Repatha be kept unrefrigerated?

Can Repatha cause high blood pressure?

See also:

Aimovig

Botox

Ozempic

Nurtec ODT

Emgality

Inderal

Ajovy

Vyepti

Botox Cosmetic

Fremanezumab

Related medical questions

Drug information

Related support groups