Pronunciation: ri-PAth-a
Generic name: evolocumab
Dosage form: prefilled single-dose SureClick autoinjector (140 mg/mL), prefilled single-dose syringe (140 mg/mL), single-dose Pushtonex system (420 mg/3.5mL; on-body infusor with prefilled cartridge)
Drug class: PCSK9 inhibitors

Medically reviewed by Carmen Pope, BPharm. Last updated on Jan 14, 2025.

What is Repatha?

Repatha is a human monoclonal antibody. It works by helping the liver reduce levels of "bad" cholesterol (low-density lipoprotein, or LDL) circulating in your blood.

Repatha (evolocumab) is used together with a low-fat diet and other cholesterol-lowering medications in people with homozygous or heterozygous familial hypercholesterolemia (inherited types of high cholesterol). These conditions can cause high blood levels of LDL cholesterol, and can also cause plaque to build up inside your arteries.

Repatha is also used to help lower the risk of stroke, heart attack, or other heart complications in people with heart or blood vessel problems caused by plaque build-up or hardening in the arteries (also called atherosclerosis, or arteriosclerosis).

Repatha received FDA approval on August 27, 2015. There is no Repatha generic or biosimilar.

How much does Repatha cost?

Repatha has broad coverage over most insurance types so the cost of Repatha depends on the type of insurance you have. For example, with the Repatha Co-Pay card, those with commercial insurance pay as little as $15 a month. For those with Medicaid, 99% of Repatha prescriptions cost people $10 or less. See How much does Repatha cost? for more information.

Repatha side effects

The most common side effects of Repatha are:

• Cold symptoms like a runny nose and sore throat
• Flu or flu-like symptoms
• Back pain
• High blood sugar/diabetes
• Injection site reactions such as redness, pain, or bruising.

Serious side effects and warnings

Repatha can cause serious side effects including:

Serious allergic reactions. Some people taking Repatha have had serious allergic reactions. Stop taking Repatha and call your healthcare provider or seek emergency medical help right away if you or your child have any of these symptoms:

• trouble breathing or swallowing
• raised bumps (hives)
• rash, or itching
• swelling of the face, lips, tongue, throat or arms.

Repatha is available as prefilled single-dose SureClick autoinjectors and prefilled single-dose syringes that either contain dry natural rubber (a derivative of latex) in the needle cover or are not made with natural rubber latex. Ask your healthcare provider for the Repatha SureClick autoinjector or injection that does not contain dry natural rubber if you are sensitive to latex. 

Tell your healthcare provider if you or your child have any side effect that bothers you or does not go away. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects or see the Repatha Package Insert. You may report side effects to the FDA at 1-800-FDA-1088.

Related/similar drugs

Before taking this medicine

You should not use Repatha if you are allergic to evolocumab, Repatha, or any ingredients in the Repatha injection (see below for a list of ingredients).

Before you or your child start using Repatha, tell your healthcare provider about all your medical conditions, including if you or your child:

• are allergic to rubber or latex. Repatha is available as prefilled single-dose SureClick autoinjectors and prefilled single-dose syringes that either contain dry natural rubber (a derivative of latex) in the needle cover or are not made with natural rubber latex. The carton and “Repatha Instructions for Use” will state if your prefilled single-dose SureClick autoinjector or prefilled single-dose syringe contains dry natural rubber.
  • The single-dose Pushtronex® system (on-body infusor with prefilled cartridge) is not made with natural rubber latex.
• have liver or kidney disease
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed.

Do not give Repatha to a child without medical advice and is not approved for use by anyone younger than 10 years old. For certain conditions, Repatha should not be given to a child of any age.

Pregnancy

It is not known if Repatha will harm your unborn baby. Tell your healthcare provider if you become pregnant while taking Repatha. If you or your child are pregnant during Repatha treatment, you are encouraged to call Amgen at 1-800-772-6436 (1-800-77-AMGEN) or visit their adverse event and product complaint reporting page to share information about the health of you and your baby or your child and your child’s baby.

Breastfeeding

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risks. If you or your child breastfeed during Repatha treatment, you are encouraged to call Amgen at 1-800-772-6436 (1-800-77-AMGEN) or visit https://wwwext.amgen.com/products/global-patient-safety/adverse-event-reporting to share information about the health of you and your baby or your child and your child’s baby.

How is Repatha given?

See the detailed Instructions for Use that come with the Repatha Package Insert about the right way to prepare and give Repatha.

• Use Repatha exactly as your healthcare provider tells you or your child to use it.
• Repatha is given under the skin (subcutaneously), every 2 weeks or 1 time each month.
• If your healthcare provider decides that you or your child or a caregiver can give Repatha, you or your child or your caregiver should receive training on the right way to prepare and inject Repatha.
  • Do not try to inject Repatha until you or your child have been shown the right way by your healthcare provider or nurse.
• You or your child can inject Repatha into the thigh, upper arm, or stomach (abdomen), except for a two-inch area around the belly button.
  • Your healthcare provider will show you the best places on your body to inject Repatha or place the on-body infusor. Use a different place each time you give an injection. Do not inject into the same place two times in a row.
  • Do not choose an area where the skin is tender, bruised, red, or hard. Avoid injecting into areas with scars or stretch.

If you or your child have HoFH, the recommended starting dose is 420 mg one time each month. After 12
weeks, your healthcare provider may increase the dose to 420 mg every two weeks.

• If you or your child receives lipid apheresis, your healthcare provider may decide to start you or your child on a dose of 420 mg every two weeks to match with the apheresis treatment and you or your child should take the dose after the apheresis treatment.

Repatha comes as a prefilled single-dose (1 time) autoinjector (SureClick autoinjector), as a prefilled single-dose syringe or as a single-dose Pushtronex system (on-body infusor with prefilled cartridge). Your healthcare provider will prescribe the type and dose that is best for you or your child.

• It may take up to 15 seconds to inject Repatha using a prefilled syringe or a SureClick autoinjector. If you use more than one injection at a time, be sure to finish all injections within 30 minutes.
• Each single-use prefilled syringe, cartridge, or injection device is for one use only. Throw away after one use, even if there is still some medicine left inside. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.
• Full patient instructions with diagrams are available on the Repatha Package Insert.
• Ask your doctor or pharmacist if you have any questions about your injection device, or call the manufacturer at 1-844-737-2842.

If your healthcare provider prescribes you or your child the 420 mg dose, you or your child may use:

• a single-dose on-body infusor with the prefilled cartridge to give the injection over 5 minutes, or
• 3 separate injections in a row, using a different prefilled single-dose SureClick autoinjector or prefilled single-dose syringe for each injection. Give all of these injections within 30 minutes.

If you or your child are using the prefilled single-dose SureClick autoinjector, put the yellow safety guard
(needle inside) of the prefilled single-dose SureClick autoinjector on the skin before injecting.

You should not stop using Repatha without your doctor's advice, or your LDL cholesterol levels may increase.

Repatha is only part of a complete treatment program that also includes diet, statin medication, and regular blood testing. Follow your doctor's instructions very closely.

Get emergency medical help if you have signs of an allergic reaction to Repatha: hives, severe itching; difficulty breathing; swelling of your face, lips, tongue, or throat.

Repatha Pushtonex system

The Pushtronex on-body infusor is a special hands-free device placed on the skin that delivers Repatha slowly. Read and carefully follow all instructions for using this product. You need to wear the device for about 9 minutes to get the full dose. While wearing the on-body infusor, you may perform moderate activities such as walking, bending, or reaching.

Repatha dosing instructions

Repatha is usually given 1 time a month or once every 2 weeks.

• Depending on your dose amount, you may need to use up to 3 separate injections at one time.
• Follow your doctor's dosing instructions very carefully.

Usual Adult Dose for Hyperlipidemia: Repatha 140 mg subcutaneously every 2 weeks OR 420 mg subcutaneously 1 time a month.

Usual Adult Dose for Heterozygous Familial Hypercholesterolemia: Repatha 140 mg subcutaneously every 2 weeks OR 420 mg subcutaneously 1 time a month.

Usual Adult Dose for Homozygous Familial Hypercholesterolemia: Repatha 420 mg subcutaneously 1 time a month.

• May increase to 420 mg every 2 weeks if clinically meaningful response is not achieved in 12 weeks.
• Adults on lipid apheresis may initiate treatment with 420 mg subcutaneously every 2 weeks to correspond with their apheresis schedule; administer after the apheresis session is complete.

Usual Adult Dose for Cardiovascular Risk Reduction: Repatha 140 mg subcutaneously every 2 weeks OR 420 mg subcutaneously 1 time a month.

Usual Child Dose (10 and older) for Homozygous Familial Hypercholesterolemia: Repatha 420 mg subcutaneously 1 time a month.

• May increase to 420 mg every 2 weeks if clinically meaningful response is not achieved in 12 weeks.
• Children on lipid apheresis may initiate treatment with 420 mg subcutaneously every 2 weeks to correspond with their apheresis schedule; administer after the apheresis session is complete.

Usual Child Dose (10 and older) for Heterozygous Familial Hypercholesterolemia: Repatha 140 mg subcutaneously every 2 weeks OR 420 mg subcutaneously 1 time a month.

What happens if I miss a dose of Repatha?

If you or your child forget to use Repatha or are not able to take the dose at the regular time, inject your or your child’s missed dose as soon as you remember, as long as it is within 7 days of the missed dose.

More than 7 days from the missed dose

If it is more than 7 days from the missed dose and you or your child are using the every-2-week dose, inject the next dose based on the original schedule. This will put you or your child back on the original schedule.

If it is more than 7 days from the missed dose and you or your child are using the 1-time each-month dose, inject the dose and start a new schedule using this date.

If you or your child are not sure when to take Repatha after a missed dose, ask your healthcare provider or pharmacist. Do not use extra medicine to make up a missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Repatha?

Do not inject Repatha into skin that is bruised, sore, scarred, or hardened.

Do not shake Repatha. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

What other drugs will affect Repatha?

Other drugs may interact with evolocumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

How do I store Repatha?

Store Repatha in the refrigerator in its original carton and protect from light and heat. Do not freeze. Throw away any medicine that has been frozen.

Take the medicine out of the refrigerator and allow it to reach room temperature for 30 to 45 minutes before injecting your dose. Do not heat a syringe or injection device.

You may also store Repatha in the original carton at cool room temperature, away from light and heat. Use the medicine within 30 days if it is kept at room temperature.

Handle this medicine carefully. Dropping an injection device can cause it to break. Do not use an injection device that has been dropped onto a hard surface, even if you cannot see a break in it. Call your pharmacist for new medicine.

What are the ingredients in Repatha?

Active ingredient: evolocumab

Inactive ingredients: proline; acetate; polysorbate 80; water for injection, USP; and sodium hydroxide.

Who makes Repatha?

Repatha (evolocumab) is made by Amgen, a biotechnology company headquartered in California. Notable drugs from Amgen include:

• Enbrel (rheumatoid arthritis, psoriasis)
• Prolia/Xgeva (osteoporosis/bone disorders)
• Neulasta/Neupogen (boost white blood cells during chemotherapy)
• Otezla (psoriasis, psoriatic arthritis)
• Lumakras (lung cancer)
• Amjevita (biosimilar to Humira)
• Epogen/Aranesp (anemia)
• Tezspire (severe asthma - partnered with AstraZeneca)

Amgen has been particularly significant in developing biologics (protein-based drugs) and biosimilars. They were one of the first biotech companies to successfully develop and commercialize recombinant DNA technology for medical treatments.

Repatha Biosimilars

Biosimilar and interchangeable products are biological products that are highly similar to and have no clinically meaningful differences from the reference product.

Reference products

These are biological products that have already been approved by the FDA, against which biosimilar products are compared. There is 1 for Repatha.

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