Evolocumab
Evolocumab is a monoclonal antibody medication used to lower LDL (bad) cholesterol levels in patients with cardiovascular disease or familial hypercholesterolemia who have not achieved adequate control with statins or who cannot tolerate statin therapy. It works by blocking the PCSK9 protein, which normally breaks down LDL receptors in the liver, allowing the liver to remove more cholesterol from the bloodstream. This medication is administered as a subcutaneous injection typically every 2 or 4 weeks.
Evolocumab is a PCSK9 inhibitor monoclonal antibody that lowers LDL cholesterol by preventing the degradation of liver LDL receptors.
Key facts at a glance
- ATC
- C10AX13
- RxNorm
- 1665684
- Generic
- Evolocumab
- Class
- atc-c10
- Brands
- Repatha
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- prefilled syringe
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 140mg every 2 weeks or 420mg once monthly
- Maximum
- consult physician
- Frequency
- every 2 weeks or once monthly
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 140mg every 2 weeks or 420mg once monthly
- Maximum
- consult physician
- Frequency
- every 2 weeks or once monthly
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 140mg every 2 weeks or 420mg once monthly
- Maximum
- consult physician
- Frequency
- every 2 weeks or once monthly
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
13 groupspregnancy
first trimesteravoid if possible
use only if benefits outweigh potential risks to fetus; consider discontinue therapy if pregnancy occurs
regular prenatal monitoring
Use with caution and monitor for adverse effects.
pregnancy
second trimesteravoid if possible
use only if benefits outweigh potential risks; consider discontinue therapy
regular fetal monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid if possible
use only if benefits outweigh potential risks
regular fetal monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedingno adjustment needed
decide whether to discontinue breastfeeding or discontinue drug; unknown if excreted in human milk
monitor infant for any adverse effects
pediatric_age
under 12 yearsnot established
safety and efficacy not established in pediatric patients; use not recommended
not applicable
pediatric_age
12 to 17 yearsno adjustment
approved for homozygous familial hypercholesterolemia in pediatric patients 12 years and older
standard lipid monitoring
geriatric
elderly over 65no adjustment
no dose adjustment required based on age; monitor renal function
standard monitoring
renal_impairment
mild renal impairmentno adjustment
no dose adjustment needed for mild renal impairment
standard monitoring
renal_impairment
moderate renal impairmentno adjustment
no dose adjustment needed for moderate renal impairment
standard monitoring
renal_impairment
severe renal impairmentno adjustment
use with caution; limited data in severe renal impairment
close monitoring
Use with caution and monitor for adverse effects.
hepatic_impairment
mild hepatic impairmentno adjustment
no dose adjustment needed for mild hepatic impairment
standard monitoring
hepatic_impairment
moderate hepatic impairmentno adjustment
use with caution; limited data in moderate hepatic impairment
close monitoring of liver function
Use with caution and monitor for adverse effects.
alcohol_users
moderate alcohol useno adjustment
no specific interaction; continue evolocumab as prescribed
standard lipid monitoring
Statistics and clinical data
Drug class
Monoclonal antibody that inhibits PCSK9 enzyme
FDA approval year
FDA approved Evolocumab under brand name Repatha
Primary indication
Treatment for hyperlipidemia and cardiovascular risk reduction
Mechanism of action
Increases LDL receptor recycling leading to reduced LDL levels
Evolocumab is indicated for heterozygous familial hypercholesterolemia (HeFH), homozygous familial hypercholesterolemia (HoFH), and atherosclerotic cardiovascular disease (ASCVD) in patients who need additional LDL lowering despite being on maximally tolerated statin therapy.
Evolocumab binds to and inhibits proprotein convertase subtilisin kexin type 9 (PCSK9), preventing it from binding to low-density lipoprotein receptors (LDLR) on hepatocytes. This prevents LDLR degradation and allows more receptors to remain on the cell surface to remove LDL cholesterol from the blood.
Common side effects include nasopharyngitis, upper respiratory tract infections, and injection site reactions. Patients should continue taking statins as prescribed unless otherwise directed by their healthcare provider. The medication is administered via subcutaneous injection and requires refrigeration storage. Safety in pregnancy and breastfeeding has not been established.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy