Can evolocumab (Repatha) cause pancreatitis?

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Last updated: July 7, 2025View editorial policy

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From the Guidelines

Evolocumab (Repatha) is not known to cause pancreatitis as a common or established side effect. The most recent and highest quality study, 1, does not mention pancreatitis as a side effect of evolocumab. Evolocumab is a PCSK9 inhibitor that works by increasing the liver's ability to remove LDL cholesterol from the blood, and its mechanism of action does not directly affect pancreatic function.

Common Side Effects

The most common side effects of evolocumab include:

  • Injection site reactions
  • Nasopharyngitis
  • Upper respiratory tract infections
  • Flu-like symptoms
  • Back pain
  • Muscle pain While all medications can potentially cause idiosyncratic reactions in some individuals, there is no strong evidence linking evolocumab to pancreatitis.

Considerations

If a patient taking evolocumab experiences symptoms of pancreatitis such as severe abdominal pain radiating to the back, nausea, vomiting, or elevated pancreatic enzymes, they should seek medical attention, but it would be important to consider other more common causes of pancreatitis rather than assuming it is medication-related.

From the Research

Evolocumab and Pancreatitis

  • There is no direct evidence in the provided studies that suggests evolocumab (Repatha) can cause pancreatitis 2, 3, 4, 5.
  • The studies primarily focus on the efficacy and safety of evolocumab in reducing low-density lipoprotein cholesterol (LDL-C) levels and its impact on cardiovascular events.
  • Adverse events reported in the studies include back pain, arthralgia, headache, muscle spasms, and pain in extremity, but pancreatitis is not mentioned as a potential side effect 3, 5.
  • A separate study on empagliflozin, a different medication, reports a case of acute pancreatitis, but this is not relevant to evolocumab 6.
  • Overall, the available evidence does not suggest a link between evolocumab and pancreatitis, but it is essential to consult the prescribing information and discuss any concerns with a healthcare professional.

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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