Does Repatha (evolocumab) interact with COVID-19?

Repatha (Evolocumab) and COVID-19 Interactions

Based on current evidence, Repatha (evolocumab) does not have any known significant drug interactions with COVID-19 or its treatments. 1

Drug Interaction Assessment

• No specific drug interactions between Repatha (evolocumab) and COVID-19 treatments have been documented in the available guidelines 1
• Unlike many other medications that interact with COVID-19 treatments, Repatha is not metabolized through the cytochrome P450 pathway that would cause interactions with antivirals like lopinavir/ritonavir 1
• Repatha is a monoclonal antibody that works by inhibiting PCSK9, which is distinct from the mechanisms of action of COVID-19 treatments 1

COVID-19 Treatment Interactions to Consider

• Protease inhibitors (like lopinavir/ritonavir) used for COVID-19 treatment can significantly interact with many medications through CYP3A4 inhibition, but this mechanism does not affect Repatha 1
• When reviewing potential drug-drug interactions for COVID-19 treatments, special attention is paid to:
  • Medications metabolized by CYP3A4
  • P-glycoprotein substrates
  • QT-prolonging medications 1, 2
• Repatha does not fall into these high-risk categories for COVID-19 treatment interactions 1

Clinical Recommendations

• Patients can continue Repatha therapy if they contract COVID-19 without concerns about direct drug interactions 1
• For patients receiving both Repatha and COVID-19 treatments:
  • No dosage adjustments of Repatha are required 1
  • No special monitoring is needed beyond standard care for COVID-19 1
• When treating patients with COVID-19 who are on multiple medications:
  • Check for drug interactions with other concurrent medications (particularly statins, which are often co-prescribed with Repatha) 1
  • Use reliable drug interaction checkers like Liverpool Drug Interaction Group database for comprehensive assessment 1

Important Considerations

• While Repatha itself doesn't interact with COVID-19 treatments, patients with hyperlipidemia often have comorbidities (diabetes, hypertension) that may worsen COVID-19 outcomes 1
• Patients with metabolic conditions may be at higher risk for severe COVID-19, requiring closer monitoring regardless of medication interactions 1
• Unlike some immunosuppressive medications that require timing adjustments around COVID-19 vaccination, Repatha does not require any special scheduling considerations for COVID-19 vaccines 1

In summary, Repatha (evolocumab) can be safely continued during COVID-19 infection and alongside COVID-19 treatments without concerns about significant drug interactions or adverse effects.