Side Effects of Repatha: What You Need to Know

Repatha (evolocumab) is a prescription drug that treats and prevents certain cardiovascular conditions, including high cholesterol, heart attack, and stroke. Repatha can cause side effects ranging from mild to serious. Examples include fatigue, joint pain, and increased blood sugar levels.

Repatha is used to:

• lower levels of certain kinds of cholesterol in adults and some children with specific conditions
• reduce the risk of heart attack or stroke, or the need for certain heart surgeries in adults with heart disease

The active ingredient in Repatha is evolocumab. (An active ingredient is what makes a drug work.) Evolocumab is a biologic drug, which means it’s made from living cells.

Repatha comes as a liquid solution that you inject under your skin. It comes in three forms:

• single-dose prefilled syringe
• single-dose prefilled auto-injector called SureClick
• single-dose prefilled cartridge in the Pushtronex system, which you wear on your body

Keep reading to learn about the common, mild, and serious side effects that Repatha can cause. For a general overview of the drug, including details about its uses, see this article.

Below are a few of the more common side effects reported by people who took Repatha in studies. These side effects can vary depending on what condition the drug is being used to treat.

More common side effects in people using Repatha to lower cholesterol levels include:

• upper respiratory tract infection, such as the common cold
• sore throat
• runny nose
• flu
• back pain
• injection site reaction

More common side effects in people using Repatha to reduce the risk of heart attack, stroke, and certain heart surgeries include:

• upper respiratory tract infection, such as the common cold
• runny nose
• sore throat
• diabetes or increased blood sugar level*

*To learn more about this side effect, see the “Side effects explained” section below.

Most common side effects of Repatha are mild. Examples of mild side effects that have been reported with this drug include:

• upper respiratory tract infection
• sore throat
• runny nose
• cough
• headache
• flu
• back pain
• urinary tract infection (UTI)
• dizziness
• muscle pain
• inflammation or swelling in your intestines or stomach, which may cause belly pain or cramping
• injection site reaction
• high blood pressure
• fatigue (low energy)*
• joint pain*
• diarrhea*
• mild allergic reaction*

*To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using Repatha unless your doctor recommends it.

Repatha may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Repatha, visit MedWatch.

Serious side effects are possible with Repatha. Serious side effects that have been reported in the drug’s studies include:

• severe allergic reaction*
• diabetes and increased blood sugar level*

*To learn more about this side effect, see the “Side effects explained” section below.

If you develop serious side effects with Repatha, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Below are answers to some frequently asked questions about Repatha’s side effects.

What are some of the dangers of using Repatha?

In most cases, Repatha’s side effects are mild and not dangerous. But it’s possible that Repatha may cause some serious side effects. For example, in the drug’s studies, some people reported an increased blood sugar level.

Symptoms of increased blood sugar include:

It’s important to let your doctor know if you have any of these symptoms with Repatha. To learn more about increased blood sugar levels with this drug, see the “Side effects explained” section below.

Can Repatha cause hair loss or weight gain?

It’s not likely. Hair loss and weight gain were not reported as side effects in studies of people using Repatha. But other medications that treat high cholesterol may cause hair loss. For example, hair loss is a rare side effect of cholesterol-lowering drugs called statins, which include:

If your doctor prescribes a statin along with Repatha to lower your cholesterol, you may have hair loss from the statin.

Also, diabetes and increased blood sugar levels are rare side effects of Repatha. In some cases, weight gain can be a symptom of these side effects.

Talk with your doctor if you have hair loss or weight gain that is bothersome. They can try to determine the cause of your symptoms and help you find ways to manage them.

Are there any side effects specific to Repatha SureClick injections?

No, the side effects of Repatha SureClick injections should be the same as those for the prefilled syringes and the Pushtronex device.

One of the more common side effects of Repatha SureClick injections and other forms of Repatha is injection site reactions. The most common kinds of reactions reported in Repatha’s studies were discoloration, pain, and bruising at the injection site. These kinds of reactions are usually not serious.

To reduce your risk of an injection site reaction, try to inject Repatha in a different location each time you use it. You can inject Repatha into your belly, thigh, or upper arm. But avoid injecting the medication in areas where your skin is irritated, bruised, tender, or discolored.

Allowing Repatha to come to room temperature before injecting it can help reduce pain during injection.

It is important to note that needle caps on Repatha SureClick injections are made using latex. This could cause an allergic reaction if you have a latex allergy. Be sure to tell your doctor if you have a latex or rubber allergy so they can prescribe a safe form of Repatha for you.

Talk with your doctor or pharmacist to learn more about ways to reduce your risk of side effects with Repatha.

Does Repatha cause liver-related side effects?

Probably not. Liver-related side effects were not reported in studies of Repatha.

Keep in mind that other drugs your doctor may prescribe along with Repatha to lower your cholesterol may have liver-related side effects.

For example, statin drugs such as Lipitor (atorvastatin) and Crestor (rosuvastatin) may cause certain liver problems. If you take these drugs together with Repatha, there’s a risk you may have liver-related side effects from the statin. But these side effects are not caused by Repatha.

Talk with your doctor or pharmacist if you have concerns about what side effects to expect from Repatha.

Learn more about some of the side effects Repatha may cause.

Fatigue (low energy)

Fatigue was a less common side effect reported in Repatha’s studies. In many cases, fatigue caused by Repatha is mild. But keep in mind that fatigue can also be a symptom of rare but more serious side effects Repatha can cause, including diabetes or increased blood sugar levels.

What might help

In most cases, fatigue caused by Repatha is mild and goes away on its own, but sometimes it can be a symptom of other serious conditions.

If you have prolonged fatigue or other symptoms such as increased thirst or dry mouth along with it, let your doctor know. These can be signs that your blood sugar level may have increased. Your doctor will likely do tests to determine the cause of your fatigue. They’ll decide on the right treatment option for you based on the cause of your fatigue.

Joint pain

It’s possible that Repatha may cause joint pain. This side effect was reported in Repatha’s studies, but it wasn’t common.

Keep in mind, though, that joint pain can be a symptom of other Repatha side effects, such as fatigue and flu.

What might help

Over-the-counter (OTC) pain relievers, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol), may help relieve your pain. You can also try resting the painful joints or applying an ice pack.

Before taking OTC medications, talk with your doctor or pharmacist. They’ll let you know if they’re safe for you based on other drugs you take or conditions you have.

Talk with your doctor if you have joint pain that’s not relieved by OTC medications. They can recommend other treatment options for you.

Increased blood sugar levels

Using Repatha can cause increased blood sugar levels or diabetes. This was a common side effect in studies of people using Repatha to help prevent stroke, heart attack, or the need for certain kinds of heart surgery. This side effect was not reported by people using Repatha to lower cholesterol.

Symptoms of high blood sugar can include:

What might help

It’s important to tell your doctor right away if you have symptoms of high blood sugar while using Repatha. If not treated, high blood sugar and diabetes can lead to serious complications over time, including kidney or eye disease and nerve damage.

If your doctor determines that you have high blood sugar, they’ll likely recommend treatment options to manage your blood sugar level. In some cases, these treatment options may include medications.

Diarrhea

Diarrhea was a common side effect reported in studies of people using Repatha. Diarrhea caused by Repatha is usually mild. Symptoms can include:

• loose or watery stools
• increased frequency of bowel movements
• increased urgency to have a bowel movement
• nausea
• bloating
• belly pain or cramping

What might help

Mild diarrhea can usually be relieved with OTC treatments, such as Imodium-AD (loperamide). But check with your doctor or pharmacist before taking OTC drugs to be sure they’re safe for you.

In some cases, diarrhea can lead to dehydration (low fluid level), so it’s important to increase your fluid intake if you have diarrhea. You can do this by drinking plenty of water and beverages containing electrolytes.

Talk with your doctor if you have severe or persistent diarrhea. They can recommend treatment options, including medication, to help manage your symptoms.

Allergic reaction

Like most drugs, Repatha can cause an allergic reaction in some people. Symptoms can be mild to serious and can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment option to manage your symptoms. Examples include:

• an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
• a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Repatha, they’ll decide whether you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Repatha, they may have you switch to a different treatment.

• what dose of the drug you were taking when you had the side effect
• how soon you had the side effect after starting that dose
• what your symptoms were
• how it affected your daily activities
• what other medications you were taking
• any other information you feel is important

Repatha may not be right for you if you have certain medical conditions. (This is known as a drug-condition interaction.)

Other factors may also affect whether Repatha is a good treatment option for you. Below are some factors to consider.

Allergic reaction. If you’ve had an allergic reaction to Repatha or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Latex or rubber allergy. Certain parts of the Repatha prefilled syringes and SureClick auto-injectors contain rubber, which is made from latex. If you have an allergy to latex or rubber, these forms of Repatha may not be safe for you to use. The Repatha Pushtronex system does not contain rubber or latex, so may be a safer option for you.

Talk with your doctor about your health history before starting this drug.

Alcohol and Repatha

It should be safe to drink alcohol during Repatha treatment. But other drugs, such as statins, which your doctor may prescribe along with Repatha to lower cholesterol, may interact with alcohol.

If you drink alcohol, talk with your doctor to learn how much alcohol, if any, is safe for you to consume while taking cholesterol-lowering drugs.

Pregnancy and breastfeeding while using Repatha

There aren’t enough studies to know if Repatha is safe to use during pregnancy or while breastfeeding. It’s not known whether Repatha passes through breast milk or how it could affect a child who is breastfed.

If you’re pregnant or planning a pregnancy, or are breastfeeding or considering it, talk with your doctor. They’ll discuss treatment options that are safe for you.

If you use Repatha during pregnancy, your doctor will likely provide information regarding the Repatha pregnancy safety study. Or you can find out more by contacting Amgen, the Repatha drugmaker, at 800-772-6436.

As with most drugs, you may have some side effects from Repatha. Many of the drug’s common side effects are mild and can be managed at home. But some side effects can be more serious and require medical attention.

Talk with your doctor before starting Repatha. They can discuss potential side effects with you and ways to manage them. Examples of questions you may want to ask include:

• Does Repatha cause any long-term side effects?
• Does my risk of increased blood sugar depend on my Repatha dosage?
• How do the side effects of Repatha compare with those of statin drugs?
• Does my risk of side effects increase if I take other cholesterol-lowering drugs along with Repatha?

To learn more about Repatha, see these articles:

• All About Repatha
• Dosage Details for Repatha
• Repatha and Cost: What You Need to Know

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Disclaimer: Austra Health has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Last medically reviewed on March 10, 2023