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Evolocumab - Indications, Dosage, Side Effects and Precautions

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Information about Evolocumab

Generic Name : Evolocumab
Up-to-date prescription details regarding Evolocumab are provided here.

Pronunciation : E-voe-LOK-ue-mab

Learn the correct pronunciation of the Evolocumab, understand it's uses, recommended dosages, its indications, how to take, when to take, when not to take, side effects, special precautions, warnings and its and its storage instructions.
You will also find a list of the medication's International and Indian brand or trade names, as well as its pricing information. For verification of the information presented on this page or for additional clarifications, it's advisable to consult your doctor.


Therapeutic Classification : Antilipemics

Trade Names/Brand Names of Evolocumab

India :


Repatha, Repatha Pushtronex

Overview of Evolocumab

• Evolocumab is a human monoclonal antibody approved by the FDA for lowering low-density lipoprotein cholesterol levels circulating in the blood.

Why is Evolocumab Prescribed? (Indications)

Evolocumab is prescribed as an adjunct to a low-fat diet and other cholesterol medications in treating patients with high low-density lipoprotein (LDL) cholesterol, total cholesterol, heterozygous familial hypercholesterolemia (HeFH) or homozygous familial hypercholesterolemia (HoFH); HeFH and HoFH are inherited conditions in which cholesterol is not removed from the body.

Evolocumab is also recommended for patients with heart disease caused by atherosclerosis (accumulation of cholesterol along the arterial walls). Atherosclerosis leads to decreased blood flow and reduced oxygen supply to the heart, brain and other parts of the body.

Evolocumab works by inhibiting a protein called proprotein convertase subtilisin kexin type 9 (PCSK9) that binds to LDL receptors on liver cells. With fewer PCSK9 proteins available, LDL receptors are free to remove LDL from the blood decreasing the chances of atherosclerosis.

When should Evolocumab not be taken? (Contraindications)

Evolocumab is not recommended in patients who are:

• Allergic to the evolocumab medication
• Below 13 years of age because of the lack of safety data for these age groups

What is the dosage of Evolocumab?

Patients with heterozygous familial hypercholesterolemia (HeFH) or primary hyperlipidemia:
• The recommended adult subcutaneous dose is 140mg/ml every 2 weeks or 420mg once a month.

Patients with homozygous familial hypercholesterolemia (HoFH):
• The adult dose is a subcutaneous injection of 420 mg once in a month.
• It is recommended to measure the LDL Cholesterol 4 to 8 weeks after initiating evolocumab treatment to know the response of evolocumab to LDL receptor.

In case of administering the 420 mg dose, it is necessary to take 3 separate injections of 140mg/ml one after the other within 30 minutes.
In case of a missed dose, the required dose has to be taken immediately; if there are 7 or less number of days for the next dose, the current dose can be omitted and the regular dosing schedule can be followed.

How should Evolocumab be taken?

• Evolocumab comes in a liquid form as a 140mg/ml solution in a prefilled syringe or a prefilled autoinjector which should be injected subcutaneously just under the skin.
• The prefilled syringes or autoinjector contain medicines only for single use and should be disposed of properly after each use.
• The injection sites are thigh, upper arm or stomach area except for the 2-inch around the navel area. Rotate the injection site after each injection.

What are the warnings and precautions for Evolocumab?

• Dosage adjustments are required in patients with kidney or liver disease.

• The injection should not be mixed with other injectables.

• Never use the injection and discard it in case it has a cloudy appearance, or discolored or visible particles are present in the solution.

• Before injecting the solution it is important to keep it at room temperature for at least 30 minutes to warm it up. However, it should not be warmed by any other techniques.

• Avoid using the injection on sore, bruised, scarred or hardened skin or on skin where stretch marks are present.

What are the side effects of Evolocumab?

Gastrointestinal: Diarrhea, nausea, abdominal pain and gastroenteritis
Cardiovascular system: Raised blood pressure, increased or decreased heartbeat
Central Nervous System: Headache and dizziness
Respiratory: Nasopharyngitis, sinusitis, influenza, cough, upper respiratory tract infections, and difficulty in breathing
Skin: Itching, rashes, injection site reactions such as erythema, pain and bruising
Others: Fever, swelling of the face or lips or eyes, weakness, backpain, myalgia or musculoskeletal pain, urinary tract infection, and dysuria (pain or burning sensation during urination)

What are the other precautions for Evolocumab?

• Treatment with evolocumab should not be stopped suddenly because the levels of LDL cholesterol may increase.
• Evolocumab is only a part of the treatment which requires frequent lipid profile testing and necessary dose adjustments as per the advice of the physician.

What are the Drug Interactions of Evolocumab?

• There are no known drug interactions for evolocumab.
• However, please let your doctor know your medical conditions, other prescription and non-prescription medicines you are taking and if you are pregnant or are breastfeeding before taking the drug.

What are the storage conditions for Evolocumab?

• Evolocumab should be stored in its original container in a refrigerator at 2°C to 8°C; it should not be placed in the freezer. It should not be shaken before use.
• It can be stored at room temperature up to 25°C in the original carton not exceeding 30 days and should be discarded if not used.
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