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EspañolRepatha is a brand-name prescription drug that helps lower “bad” cholesterol (LDL cholesterol) in people with high cholesterol or established cardiovascular disease. Its active ingredient, evolocumab, is a monoclonal antibody that helps the liver break down LDL cholesterol faster. The injections are given every two weeks or once a month using either a prefilled syringe, a prefilled autoinjector, or a Pushtronex on-body infusor to infuse monthly large doses.
Repatha forms and strengths
Injections are the only dosage form, but there are three ways to administer Repatha:
Prefilled syringe: 140 mg/mL
SureClick prefilled autoinjector: 140 mg/mL
Pushtronex System prefilled on-body infusor: 420 mg/3.5 mL
Repatha dosage for adults
Repatha is a cholesterol-lowering biologic medication taken every two to four weeks. It is often prescribed with a statin or other lipid-lowering therapy. Unlike statins, Repatha only reduces low-density lipoprotein (LDL or “bad”) cholesterol levels. It is used in people who already have high cholesterol, hereditary high cholesterol, or who have been diagnosed with cardiovascular disease. Injections are self-administered under the skin every other week or once a month. Monthly injections, however, are infusions. That means the injection takes five minutes to complete, so patients will use an electronic on-body infuser to perform the slow injection.
Repatha dosage chart |
|||
|---|---|---|---|
| Indication | Starting dosage | Standard dosage | Maximum dosage |
| High cholesterol | 140 mg every 2 weeks or 420 mg every 4 weeks | 140 mg every 2 weeks or 420 mg every 4 weeks | 420 mg every 4 weeks |
| For risk reduction in adults with cardiovascular disease | 140 mg every 2 weeks or 420 mg every 4 weeks | 140 mg every 2 weeks or 420 mg every 4 weeks | 140 mg every 2 weeks or 420 mg every 4 weeks |
| For hereditary high cholesterol (familial hypercholesterolemia) | 140 mg every 2 weeks or 420 mg every 4 weeks | 140 mg every 2 weeks or 420 mg every 4 weeks | 420 mg every 2 weeks |
Repatha dosage for high cholesterol
Healthcare providers use Repatha to lower LDL-C cholesterol in people diagnosed with primary hyperlipidemia, that is, high fat and cholesterol levels in the blood. Patients will most likely be taking other lipid-lowering therapies such as statins. Called a PCSK9 inhibitor, evolocumab is a synthetic antibody that prevents a protein from shutting down the liver cells that break down LDL-C cholesterol. As a result, the liver more actively removes LDL cholesterol from the blood.
Standard Repatha dosage for high cholesterol: 140 mg every 2 weeks or 420 mg every 4 weeks
Repatha dosage for risk reduction in people with cardiovascular disease
For people with established cardiovascular disease, Repatha lowers LDL cholesterol to reduce the risk of heart attack, stroke and the need for surgical procedures to restore blood flow to the heart (coronary revascularization). Again, most people will take another cholesterol-lowering prescription drug in addition to their biweekly or once-monthly dose of Repatha.
Standard Repatha dosage for high cholesterol: 140 mg every 2 weeks or 420 mg every 4 weeks
Repatha dosage for familial hypercholesterolemia
Some people are born with an impaired ability to clear LDL cholesterol from the body. This impairment causes dangerously high cholesterol levels to build up in the blood. Doctors diagnose hereditary high cholesterol as either homozygous familial hypercholesterolemia (HoFH) or heterozygous familial hypercholesterolemia (HeFH), depending on the type of genetic defect. The FDA has approved Repatha for both conditions in adults and children as young as 10 years of age. Again, patients will take injections once every two weeks or once every four weeks, along with other cholesterol-lowering medications.
Standard Repatha dosage for familial hypercholesterolemia: 140 mg every 2 weeks or 420 mg every four weeks. In certain people, the dose may be increased to 420 mg every two weeks if ideal cholesterol levels are not achieved.
Repatha dosage for children
Children 10 years of age or older who were born with familial hypercholesterolemia can take Repatha along with other cholesterol-lowering drugs to control LDL cholesterol levels. Dosages are the same as for adults.
Repatha dosage restrictions
No dosage adjustments are required in people with kidney disease, liver disease, or advanced age.
How to take Repatha
Repatha is a self-administered subcutaneous injection. Repatha can be injected every two weeks using a prefilled syringe or auto-injector. Monthly injections take five minutes, so they are self-administered using an electronic single-dose on-body infusor.
BEFORE YOU START
Store this medicine in its original carton in the refrigerator. Do not freeze.
The medicine can be stored at room temperature for up to 30 days. After that, it should be thrown away.
Never allow the medicine to sit in direct sunlight.
Make sure a healthcare provider has shown you how to use your injection method of choice. Clear up any questions or confusion you have during that demonstration.
Before each injection, review Amgen’s demonstration videos or read the Instructions for Use included in the package.
Each device is single-use. Use a new autoinjector, syringe, or infusor for each injection. Do not give more than one injection per device or save leftover medicine in a used device.
Always check the syringe, autoinjector, or infusion device. Do not use it if the medicine is cloudy, the device is damaged, parts are missing, or the expiration date has passed.
Do not use the syringe, autoinjector, or infusion device if you drop it.
Do not shake the syringe, autoinjector, or infusion device.
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 with cuts, scrapes, scars, or stretch marks.
Always clean the injection area with an alcohol wipe before injecting the medicine.
HOW TO USE THE REPATHA SURECLICK AUTOINJECTOR
Allow the autoinjector to get to room temperature by pulling it out of the fridge and waiting for at least 30 minutes before you use it. Do not heat it. Let it come to room temperature on its own.
Self-administered injections can be given on the thigh or abdomen.
A caregiver can administer an injection on the outer area of the upper arm.
Pull the orange cap off the injector when ready to inject.
Stretch or pinch the skin to provide an injection surface.
Put the yellow safety guard at the end of the injector against the skin surface at a 90-degree angle.
Without pressing the gray button, push the injector down until it can’t move anymore.
Press the gray button. It will click.
The injection takes 15 seconds. You can lift your thumb but keep the injector pushed tightly against the skin.
When the window turns yellow, the injection is finished. You may hear a second click.
You can remove the injector and dispose of it in a sharps container.
HOW TO USE THE REPATHA PREFILLED SYRINGE
Allow the prefilled syringe to get to room temperature by pulling it out of the fridge and waiting for at least 30 minutes before you use it. Do not heat it. Let it come to room temperature on its own.
Self-administered injections can be given on the thigh or abdomen.
A caregiver can administer an injection on the outer area of the upper arm.
Gently remove the syringe from the tray. NEVER pick up the syringe by the plunger rod or gray needle cap.
Always hold the syringe by the syringe barrel.
Remove the gray needle cover.
Pinch your skin at the injection site.
At a 45- or 90-degree angle, push the syringe needle into the skin.
Push the plunger down slowly until all the medicine has been injected.
Take your thumb off the plunger and gently remove the needle.
Dispose of the empty syringe in a sharps container.
HOW TO USE THE REPATHA PUSHTRONEX SYSTEM
You must be trained by a healthcare professional before you use this device.
If the infusor is used on a child, an adult caregiver should administer Repatha and supervise the child during the entire infusion.
Allow the on-body infusor to get to room temperature by pulling it out of the fridge and waiting for at least 45 minutes before you use it. Do not heat it. Let it come to room temperature on its own.
When ready, open the carton.
NEVER press the START button until the prefilled cartridge is inserted, the infusor is attached to the skin, and you are ready to start the injection.
Open the cartridge door on the infusor. DO NOT CLOSE IT until the prefilled cartridge is fully inserted.
Clean the prefilled cartridge bottom with an alcohol wipe.
Insert the prefilled cartridge into the infusor and press down firmly on it.
Close the cartridge door tight until you hear it snap.
Once the prefilled cartridge is inserted, the injection must start within 5 minutes.
Pull the green tabs to expose the adhesive. This will turn the cartridge on and a blue light will flash.
The infusor can be placed on the abdomen (stretch the skin before applying the infusor) or the upper thigh (do not stretch the skin).
Attach the infusor to the skin. Run your fingers along the adhesive to firmly attach it. The infusor should be lying flat on the skin.
Press and release the START button.
The light will flash green to signal the start of the infusion, and you will hear the pump start.
The injection takes five minutes.
When it is finished, the light will stop flashing and become solid green. The device will beep. The medicine window will only show the plunger.
Carefully remove the device by pulling on the adhesive.
Dispose of the entire device in a sharps container.
Repatha dosage FAQs
How long does it take Repatha to work?
In clinical trials, Repatha taken with a statin reduced LDL-C by an average of 63% in 12 weeks, a reduction sustained over a total of 72 weeks. Statin therapy and a placebo produced only a small decline in LDL-C.
What happens if I miss a dose of Repatha?
Make sure you understand what to do in case of a missed dose. If you are ever uncertain, call the prescribing healthcare provider.
A missed dose can be taken seven days after its scheduled time, whether biweekly or monthly. In that case, the next scheduled dose can be taken using the original schedule.
If a biweekly 140 mg dose is missed and more than seven days have passed, skip the missed dose and take the next dose as scheduled.
If a monthly 420 mg dose is missed and more than seven days have passed, then take a monthly dose and start a new monthly schedule. The next dose should be taken exactly one month later.
How long can you take Repatha?
Repatha is intended for long-term or even lifelong use. Clinical trial follow-ups have continued for over eight years without discovering long-term side effects, complications, or increased risk of side effects. However, people who have a hypersensitivity reaction to Repatha should stop taking doses and immediately contact the prescriber for medical advice.
Is it safe to take Repatha during pregnancy?
There isn’t much information about the safety of Repatha when taken while pregnant or breastfeeding. Healthcare providers do not believe that Repatha will harm a fetus, affect lactation, or cause problems in a nursing infant, but they are not certain.
What should I know about the side effects of Repatha?
Adverse reactions are fairly common in people taking Repatha, but they are rarely serious. Severe allergic reactions such as angioedema are the only worry. People with latex allergy should be aware that both the prefilled syringe and the autoinjector have needle covers made of rubber.
More common side effects include runny nose and sore throat (nasopharyngitis), upper respiratory tract infections, back pain, and injection site reactions such as bruising, redness, or pain.
Sources
Familial hypercholesterolemia, StatPearls
Repatha patient website, Amgen
Repatha prescribing information, DailyMed, NIH National Library of Medicine
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