Repatha is an injectable proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitor that is used to lower cholesterol, specifically low-density lipoprotein (LDL) levels. It is also used to reduce the risk of heart attacks, strokes, and coronary revascularization in those with cardiovascular disease. It is available as a prefilled syringe, autoinjector, and on-body infusor.
Repatha overview
BRAND NAMES:
Repatha
Generic Names:
Evolocumab
Uses:
Treats high levels of LDL cholesterol. Reduces the risk of heart attack, stroke, and heart surgery in patients with a heart and blood vessel disease.
Therapeutic Classes:
PCSK9 inhibitor, antihyperlipidemic
Forms:
Injectable
How it’s taken:
By subcutaneous injection
What is Repatha used for?
Repatha is used to reduce LDL levels in those with primary hyperlipidemia, including familial hypercholesterolemia. It can be used alone or in combination with other lipid-lowering medications, such as statins and ezetimibe. It also is prescribed to lower the risk of heart attack, stroke, and coronary vascularization, which is a procedure that improves blood flow to the heart.
Key takeaways
Repatha should not be used in patients with a history of a serious allergic reaction to it. If signs or symptoms of a serious allergic reaction occur, seek medical help immediately.
If a mild rash or itching occurs, seek medical advice from your prescriber. This may be able to be resolved by changing administration techniques.
The needle covers of the prefilled syringe and autoinjector contain a latex derivative. Caution should be used for those sensitive or allergic to latex.
Common adverse reactions of Repatha include an increased risk of respiratory infections, increased blood sugar, back pain, and injection site reactions. Talk to your prescriber if you experience any of these side effects.
What form(s) does Repatha come in
Prefilled syringe: 140 mg/mL
Prefilled SureClick autoinjector: 140 mg/mL
Pushtronex system (on-body infusor with prefilled cartridge): 420 mg/3.5 mL
What are common Repatha doses?
Cardiovascular disease or primary hyperlipidemia: 140 mg every 2 weeks or 420 mg once monthly
Homozygous familial hypercholesterolemia (HoFH): 420 mg once monthly
Common Repatha prescriptions
Repatha
1ml of 140mg/ml syringe
How to take Repatha
This medicine 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 form and dose that is right for you.
Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin. It is usually given in the stomach, thighs, or upper arms.
You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
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. Do not inject into skin areas that have cuts, scrapes, scars, or stretch marks.
Allow the autoinjector or syringe to get to room temperature by pulling it out of the fridge and waiting for at least 30 minutes before you use it, or for at least 45 minutes for the single-use Pushtronex system. Do not heat or shake the medicine.
Each device is single-use. Use a new autoinjector or syringe for each injection. Do not give more than one injection per device or save leftover medicine in a used device.
If you need more than one injection to get your full dose, give all of the injections within 30 minutes.
Carefully follow your doctor's instructions about any special diet.
Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
If you store this medicine at home, keep it in the refrigerator. Do not freeze it. You may also keep the medicine in the original carton at room temperature for up to 30 days. Throw away any unused medicine after 30 days.
What to do if you miss a dose of Repatha
Take a dose as soon as you remember, as long as it is within 7 days of the missed dose.
If it is more than 7 days from your missed dose and you are using an every-2-week dose, skip the missed dose and inject the next dose based on your regular schedule.
If it is more than 7 days from your missed dose and you are using a once-monthly dose, inject the dose and start a new schedule using this date.
Repatha contraindications
This medicine is not right for everyone. Do not use it if you have had an allergic reaction to evolocumab.
Repatha warnings
Tell your doctor if you are pregnant, breastfeeding, or have a latex allergy.
Keep all medicine out of the reach of children. Never share your medicine with anyone.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
Repatha interactions
There were no clinically significant interactions observed by Amgen’s studies when seeking FDA approval for Repatha.
Caution should be used when taking Repatha with other medications that increase blood sugar, such as antipsychotics and corticosteroids.
Repatha side effects
Repatha may cause some side effects, most of which are not serious. However, if there are signs of a severe allergic reaction, it is important to get medical help right away. If less serious side effects occur, you should speak to your prescribing healthcare provider in order to address them and see if they can be resolved or prevented.
Serious side effects:
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Less serious side effects:
Pain, itching, burning, swelling, or a lump under your skin where the shot was given
Cough, stuffy or runny nose, sore throat
Back pain
Sources:
Highlights of Prescribing information, Amgen (2017)
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