What is the equivalent dose of Repatha (Evolocumab) if I want to give the same effect as Epoetin Alfa-epbx (Epoetin Alfa) Solution, 10,000 units/mL, injected subcutaneously once weekly?

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Critical Error in Question: These Are Completely Different Medications

There is no equivalent dose of Repatha (evolocumab) for Epoetin Alfa-epbx because these are entirely different drug classes treating completely different conditions—this question appears to be based on a fundamental misunderstanding.

Why This Question Cannot Be Answered

  • Epoetin Alfa-epbx is an erythropoiesis-stimulating agent (ESA) used to treat anemia by stimulating red blood cell production, typically dosed at 150 units/kg three times weekly or 40,000 units weekly subcutaneously for chemotherapy-associated anemia 1

  • Repatha (evolocumab) is a PCSK9 inhibitor monoclonal antibody used to lower LDL cholesterol in patients with hyperlipidemia and cardiovascular disease, dosed at 140 mg every 2 weeks or 420 mg monthly subcutaneously 1

These Medications Have No Therapeutic Overlap

Epoetin Alfa treats:

  • Chemotherapy-associated anemia 1
  • Targets hemoglobin levels (goal: maintain lowest level to avoid transfusions, typically 10-12 g/dL) 1
  • Works by stimulating erythropoietin receptors to increase red blood cell production 1

Repatha (evolocumab) treats:

  • Primary hyperlipidemia, familial hypercholesterolemia, and atherosclerotic cardiovascular disease 1
  • Targets LDL cholesterol reduction (reduces LDL-C by approximately 60%) 1, 2
  • Works by inhibiting PCSK9 protein to increase LDL receptor availability 1, 3

Clarification Needed

If you are treating anemia: Continue Epoetin Alfa-epbx at 10,000 units/mL weekly as prescribed, following FDA-approved dosing for ESAs 1

If you are treating hyperlipidemia: Use Repatha at standard dosing of 140 mg subcutaneously every 2 weeks or 420 mg monthly, independent of any anemia treatment 1, 2

If the patient needs both medications: They can be administered concurrently for their respective indications, as there is no pharmacologic interaction between cholesterol-lowering therapy and erythropoiesis-stimulating agents—but there is no dose conversion or equivalence between them.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Evolocumab: A Review in Hyperlipidemia.

American journal of cardiovascular drugs : drugs, devices, and other interventions, 2016

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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