How to Inject Repatha
Repatha (evolocumab) comes as a prefilled syringe, SureClick autoinjector, or Pushtronex system for subcutaneous injection under the skin. Inject once every 2 weeks or once monthly as prescribed—typically 140 mg every 2 weeks or 420 mg monthly. Choose abdomen, thigh, or upper arm (avoid 2 inches around navel). Clean site with alcohol swab, pinch skin, insert needle at 90-degree angle, and push plunger fully. Hold 10-15 seconds post-injection to ensure dose delivers. Discard used device in sharps container.[1][2]
Step-by-Step Instructions by Device
Prefilled Syringe: Remove cap, pull back plunger slightly to check air bubble, expel it, pinch skin, insert bevel-up, inject slowly, withdraw needle.
SureClick Autoinjector: Unlock by pulling off cap, place against skin (yellow indicator shows), press firmly until click, hold until click stops and window turns yellow.
Pushtronex (on-body infusor for 420 mg): Peel adhesive, apply to clean skin, start with on-button; green lights indicate progress (30 minutes total). Remove when red light flashes.
Full video demos and patient guides are on the Amgen site or app.[2]
Dosage for Different Conditions
- High cholesterol (with statin): 140 mg every 2 weeks or 420 mg monthly.
- With other drugs: Same, often alongside statins or ezetimibe.
- Homozygous familial hypercholesterolemia: 420 mg monthly.
Adjust for kidney/liver issues minimally; no dose change needed. Kids 10+ with HoFH get 420 mg monthly. Doctor sets based on LDL goals.[1][3]
Where and When to Inject
Any time of day, with/without food. Rotate sites to avoid irritation. If missed dose, inject ASAP within 7 days, then resume schedule—don't double up. Store in fridge (discard if >36°C/97°F); can room-temp up to 30 days unopened.[2]
Common Mistakes and What Happens If You Mess Up
Injecting into muscle/vein instead of fat causes pain/bruising—re-inject if blood appears. Air bubbles are okay if small; don't shake vial. Overdose rare but watch for low cholesterol symptoms like fatigue. Mild site reactions (redness, itching) hit 5-10% of users; rotate spots. Severe allergic reactions (rash, swelling) need ER.[1][4]
Storage and Travel Tips
Refrigerate 36-46°F (2-8°C), protect from light. For travel, use cooler pack; okay at room temp <77°F (25°C) for 30 days max. Don't freeze. Check expiration; multi-use Pushtronex good for 30 days post-activation.[2]
Who Should Avoid or Adjust Repatha
Pregnant/breastfeeding? Limited data—discuss risks (fetal harm possible in animals). Hypersensitive to evolocumab? Contraindicated. No major interactions with statins/PCSK9 rivals, but monitor LDL drop. Get LDL checked 4-8 weeks after start.[3][4]
[1]: Repatha Prescribing Information (Amgen, 2023)
[2]: Repatha Official Instructions (Amgen Patient Site)
[3]: Drugs.com Repatha Dosing
[4]: FDA Label Summary