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Repatha Side Effects: What the Trials Found

The most common Repatha side effects are cold symptoms, upper respiratory infections, flu, back pain and mild injection-site reactions. In the 52-week label trial, each affected about 1 in 10 people or fewer, and each also showed up on placebo at a similar rate.

What are the side effects of Repatha?

Repatha (evolocumab) is an antibody you inject under the skin every 2 weeks or once a month to lower LDL cholesterol (LDL-C). In the trials, the most common side effects were cold symptoms, upper respiratory infections, flu, back pain and mild reactions where the shot goes in.

Each one happened only slightly more often than on placebo injections. The FDA label has no drug interaction section.

How common are Repatha side effects?

The label's 52-week placebo-controlled trial included 599 people on Repatha 420 mg monthly and 302 on placebo. No single side effect affected more than about 1 in 10 people. Side effects led 2.2% of people on Repatha to stop treatment, compared with 1% on placebo.

The larger FOURIER trial followed 27,525 people for a median of about two years. Apart from injection-site reactions, it found no significant difference in side effects between Repatha and placebo.

Rates from the 52-week trial (Repatha vs placebo):

  • Cold symptoms: 10.5% vs 9.6%
  • Upper respiratory infection: 9.3% vs 6.3%
  • Flu: 7.5% vs 6.3%
  • Back pain: 6.2% vs 5.6%
  • Injection-site reactions: 5.7% vs 5.0%
  • Muscle aches (myalgia): 4.0% vs 3.0%
  • High blood pressure: 3.2% vs 2.3%

How can I reduce injection-site reactions?

Injection-site reactions mean redness, pain or bruising where you gave the shot, and they're usually mild. Across eight pooled trials they happened in 3.2% of people on Repatha and 3.0% on placebo, and 0.1% stopped Repatha because of them. In FOURIER they were the one side effect clearly more common on Repatha (2.1% vs 1.6%).

The label's tips:

  • Let the pen or syringe sit out of the fridge for at least 30 minutes so it reaches room temperature.
  • Inject into the belly, thigh or upper arm, and use a different spot each time.
  • Skip skin that is tender, bruised, red, hard, scarred or stretch-marked.

Does Repatha affect memory or raise diabetes risk?

Both were tested directly. EBBINGHAUS followed 1,204 people on Repatha or placebo (on top of a statin) for a median of 19 months with formal cognitive testing. It found no significant differences in executive function, working memory, episodic memory or psychomotor speed.

In FOURIER, among people without diabetes at the start, new-onset diabetes occurred in 8.1% on Repatha and 7.7% on placebo, a gap small enough to be chance (hazard ratio 1.05; 95% CI 0.94 to 1.17). Blood sugar and HbA1c stayed similar between groups.

Longer follow-up showed the same pattern. In FOURIER-OLE, 6,635 people continued Repatha for a median of 5 more years (maximum exposure 8.4 years). Rates of serious side effects, muscle problems, new diabetes and neurocognitive events stayed at or below the original placebo group's rates.

What about latex and allergic reactions?

Some Repatha autoinjectors and syringes have dry natural rubber, a latex derivative, in the needle cover. If you're sensitive to latex, tell your prescriber first. The label recommends a presentation made without it.

In pooled trials, allergic-type reactions occurred in 5.1% of people on Repatha and 4.7% on placebo, most often rash (1.0% vs 0.5%). The label notes that angioedema has been reported, and that anyone with a past serious allergic reaction to evolocumab shouldn't take it.

When should I call my clinician?

Get emergency care for swelling of the face, lips, tongue or throat, or trouble breathing. Call your prescriber about a rash or hives, an injection-site reaction that spreads or doesn't fade, or any side effect that bothers you or doesn't go away. Also check in if:

  • You have a latex allergy and aren't sure which device you were given.
  • You miss a dose. The label says to take it within 7 days and keep your schedule. After 7 days, the right step depends on your dose schedule.
  • You're pregnant or planning to be.

Trials in this guide

Each links to a plain summary with a quote from the PubMed abstract.

  • EBBINGHAUS (2017) · Evolocumab · 1,204 peopleNo excess harm vs placebo
  • FOURIER (2017) · Evolocumab · 27,564 peopleBenefit
  • FOURIER-OLE (2022) · Evolocumab · 6,635 peopleLong-term safety; benefit sustained

Common questions

▸What are the most common side effects of Repatha?

In the 52-week placebo-controlled trial: cold symptoms (10.5% vs 9.6% on placebo), upper respiratory infections (9.3% vs 6.3%), flu (7.5% vs 6.3%), back pain (6.2% vs 5.6%) and injection-site reactions (5.7% vs 5.0%). Most happened nearly as often on placebo.

▸Does Repatha cause muscle pain?

Slightly more often than placebo in one trial. Muscle aches occurred in 4.0% of people on Repatha and 3.0% on placebo in the 52-week trial.

▸Can I use Repatha if I have a latex allergy?

Tell your prescriber first. Some autoinjectors and syringes have dry natural rubber in the needle cover, and the label recommends a presentation made without it.

▸Does Repatha affect your memory?

EBBINGHAUS tested memory and thinking in 1,204 people for a median of 19 months and found no difference between Repatha and placebo. In FOURIER, neurocognitive events were not significantly different either.

▸Does Repatha raise blood sugar or cause diabetes?

FOURIER found no significant increase. New-onset diabetes occurred in 8.1% on Repatha and 7.7% on placebo (hazard ratio 1.05, 95% CI 0.94 to 1.17), and HbA1c stayed similar between groups.

▸Is Repatha safe long term?

In FOURIER-OLE, 6,635 people continued Repatha for a median of 5 more years (maximum 8.4 years). Rates of serious side effects, muscle problems, new diabetes and neurocognitive events did not exceed the original placebo rates and did not rise over time.

The full guideRead the complete, referenced version on Preval Health More detail, every study, and the date each figure was checked.

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Sources

Not medical advice. General education from published trials and drug labels, last updated October 2026. lipid.site is not a healthcare provider and cannot tell you what to take or change. Talk to your clinician before starting or stopping any treatment. If you have chest pain or other signs of a heart attack or stroke, call 911.