Is there an association between Repatha (Evolocumab) and new onset tremors?

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Last updated: May 29, 2025View editorial policy

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From the Guidelines

Repatha (evolocumab) is not commonly associated with new onset tremors as a side effect, and if you are experiencing tremors after starting Repatha, you should contact your healthcare provider to rule out other potential causes 1. The most common side effects of Repatha include injection site reactions, nasopharyngitis, upper respiratory tract infections, flu-like symptoms, back pain, and muscle pain. Neurological side effects like tremors are not typically listed among the known adverse effects. Some key points to consider:

  • Repatha has been shown to reduce LDL cholesterol levels and cardiovascular risk in patients with established cardiovascular disease 1.
  • The FOURIER trial demonstrated a 59% reduction in LDL cholesterol levels and a 15% relative risk reduction in major adverse cardiovascular events with evolocumab therapy 1.
  • The ODYSSEY OUTCOMES trial also showed a significant reduction in major adverse cardiovascular events with alirocumab therapy 1. Your doctor may need to evaluate other potential causes of tremors, including other medications you may be taking, underlying medical conditions, or physiological factors like stress or caffeine consumption. Do not discontinue Repatha without medical guidance, as it plays an important role in managing cholesterol levels and reducing cardiovascular risk. Your doctor might consider temporarily stopping Repatha to determine if the tremors resolve, or they may recommend additional testing to identify the cause of your symptoms.

From the Research

Repatha and New Onset Tremors

  • There is no direct evidence in the provided studies that links Repatha (evolocumab) to new onset tremors 2, 3, 4, 5, 6.
  • The studies primarily focus on the efficacy and safety of evolocumab in reducing low-density lipoprotein cholesterol (LDL-C) levels in patients with hypercholesterolemia or mixed dyslipidemia 2, 3, 4, 5.
  • Adverse events reported in the studies include back pain, arthralgia, headache, muscle spasms, and pain in extremity, but tremors are not specifically mentioned 4, 6.
  • Further research would be needed to determine if there is a potential link between Repatha and new onset tremors, as the current evidence does not provide a clear answer to this question 2, 3, 4, 5, 6.

Safety and Efficacy of Repatha

  • Evolocumab has been shown to be effective in reducing LDL-C levels in patients with primary hypercholesterolemia or mixed dyslipidemia, including those who are statin-intolerant 2, 4, 5.
  • The medication has been found to be generally well-tolerated, with common adverse events including injection-site reactions, back pain, and arthralgia 4, 6.
  • A large clinical trial (FOURIER) demonstrated that evolocumab significantly reduced the risk of cardiovascular events in patients with atherosclerotic cardiovascular disease, with no significant difference in adverse events compared to placebo, except for injection-site reactions 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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