Repatha Is a PCSK9 Inhibitor Injection That Lowers LDL Cholesterol

Repatha (Evolocumab) is a prescription injectable medication used to significantly lower LDL ("bad") cholesterol in adults and certain children who haven't reached their cholesterol goals with statins alone. It belongs to a class of drugs called PCSK9 inhibitors and is manufactured by Amgen.

If you or someone you care about has been prescribed Repatha — or you're researching whether it might be right for you — this guide covers everything you need to know: what it is, what it treats, how it's taken, who shouldn't use it, and how much it costs.

What Is Repatha?

Here are the key facts:

• Brand name: Repatha
• Generic name: Evolocumab
• Drug class: PCSK9 inhibitor (proprotein convertase subtilisin/kexin type 9 inhibitor)
• Manufacturer: Amgen
• FDA approval: Originally approved in 2015
• Controlled substance: No — Repatha is not a controlled substance
• Biosimilar available: No generic or biosimilar is currently available in the US

Repatha is a monoclonal antibody — a type of biologic medication made from living cells. It works by blocking a protein called PCSK9, which allows your liver to remove more LDL cholesterol from your blood. For a detailed explanation, see our guide on how Repatha works.

What Is Repatha Used For?

Repatha is FDA-approved for the following uses:

1. Primary Hyperlipidemia (Including Heterozygous Familial Hypercholesterolemia)

Repatha is used as an add-on to diet and maximally tolerated statin therapy in adults who need additional LDL cholesterol lowering. This is the most common reason doctors prescribe Repatha.

2. Homozygous Familial Hypercholesterolemia (HoFH)

For patients 10 years and older with HoFH — a rare genetic condition that causes extremely high cholesterol from birth — Repatha is used alongside diet and other LDL-lowering therapies.

3. Cardiovascular Risk Reduction

In adults with established atherosclerotic cardiovascular disease (ASCVD), Repatha is approved to reduce the risk of heart attack, stroke, and coronary revascularization procedures. This was demonstrated in the landmark FOURIER clinical trial.

Some doctors also prescribe Repatha off-label for statin-intolerant patients who need significant LDL reduction or for post-acute coronary syndrome patients requiring aggressive LDL lowering.

How Is Repatha Taken?

Repatha is given as a subcutaneous injection (under the skin). Here's what you need to know about dosing:

• Standard dose: 140 mg every 2 weeks or 420 mg once monthly
• For HoFH: 420 mg once monthly (may increase to every 2 weeks if needed after 12 weeks)
• Injection sites: Thigh, abdomen, or upper arm — rotate sites with each injection
• Preparation: Let Repatha warm to room temperature for about 30 minutes before injecting

Available Forms

• 140 mg/mL prefilled syringe — for the every-2-weeks dose
• 140 mg/mL SureClick autoinjector — a pen-like device that's easier for self-injection
• 420 mg/3.5 mL Pushtronex system — an on-body infusor for the once-monthly dose, worn on the skin for about 5 minutes

For the 420 mg monthly dose using syringes, you'll give yourself three 140 mg injections consecutively within 30 minutes.

Storage

Repatha must be refrigerated at 36°F to 46°F (2°C to 8°C). It can be stored at room temperature up to 77°F (25°C) for up to 30 days in the original carton. Do not freeze or shake it.

Who Should Not Take Repatha?

Repatha has only one formal contraindication:

• Hypersensitivity: Do not take Repatha if you have a history of serious allergic reaction to Evolocumab or any of its inactive ingredients.

Additionally, Repatha is not recommended for:

• Pregnant women (insufficient safety data)
• Breastfeeding mothers (unknown if it passes into breast milk)

Always tell your doctor about all medications, supplements, and health conditions before starting Repatha. For more details, see our guide on Repatha drug interactions.

How Much Does Repatha Cost?

Repatha is an expensive specialty medication. Here's a breakdown of what patients typically pay:

• Cash price: Approximately $500–$700 per month for the 140 mg prefilled syringe or autoinjector
• Annual list price: Approximately $5,850 per year (after Amgen's net price reduction)
• With commercial insurance + copay card: As little as $5 per month through the Amgen Repatha Copay Card
• Medicare/Medicaid: Covered with prior authorization, but copay cards are not available for government insurance
• Uninsured patients: May qualify for free Repatha through the Amgen Safety Net Foundation (income at or below 400% of the federal poverty level)

For a complete guide to reducing your out-of-pocket costs, read our article on how to save money on Repatha.

Final Thoughts

Repatha is a powerful cholesterol-lowering medication that has helped millions of patients reduce their LDL levels and lower their risk of heart attacks and strokes. It's not a first-line treatment — it's typically prescribed after statins and other therapies haven't been enough. But for the patients who need it, the results can be dramatic.

If you've been prescribed Repatha, work with your doctor to understand the dosing schedule, learn how to self-inject properly, and explore savings programs to keep costs manageable. And if you're having trouble finding it at a pharmacy, search on Medfinder to check availability near you.

Learn more: Repatha side effects | How Repatha works | Find a doctor who prescribes Repatha