From the Guidelines
Repatha (evolocumab) can generally be taken with oral contraceptive pills (OCPs) as there are no known significant drug interactions between them. You should continue taking both medications as prescribed by your healthcare provider. Repatha is a PCSK9 inhibitor that lowers cholesterol levels by increasing the liver's ability to remove LDL cholesterol from the blood, while OCPs contain hormones (estrogen and/or progestin) that prevent pregnancy. These medications work through different mechanisms in the body, which is why they typically don't interfere with each other. However, it's essential to note that some OCPs, particularly those containing estrogen, can potentially increase cholesterol levels slightly, so your doctor may want to monitor your lipid levels more closely 1. Always inform all your healthcare providers about all medications you're taking, including prescription drugs, over-the-counter medications, and supplements to ensure there are no potential issues specific to your individual health situation. The provided evidence does not suggest any significant interactions between Repatha and OCPs, and the most recent study 1 does not indicate any concerns regarding their concomitant use. In contrast, the older study 1 discusses various drug interactions with OCPs but does not mention Repatha or any other PCSK9 inhibitors, further supporting the notion that Repatha and OCPs can be taken together without significant concerns. Key points to consider include:
- Repatha's mechanism of action as a PCSK9 inhibitor
- OCPs' role in preventing pregnancy and potential effects on cholesterol levels
- The importance of monitoring lipid levels when taking both medications
- Informing healthcare providers about all medications being taken to ensure safe and effective treatment.
From the Research
Repatha and OCP Interaction
- There is no direct evidence in the provided studies regarding the interaction between Repatha and Oral Contraceptive Pills (OCP).
- However, the studies discuss the increased risk of thromboembolic events associated with the use of OCP, particularly in women over 35 years old and those with a history of hypertension or smoking 2, 3, 4, 5.
- The studies also mention that progestogen-only contraceptives (POCs) may be a safer option for women with multiple cardiovascular risk factors, as they are associated with a lower risk of cardiovascular events compared to combined oral contraceptives (COCs) 2, 4.
- The effects of OCP on the haemostatic system, including increased coagulation activity and enhanced platelet activity, may be relevant when considering the use of Repatha, which is a medication used to lower cholesterol levels 6, 5.
- It is essential to consult with a healthcare professional to determine the safety and efficacy of taking Repatha with OCP, as individual factors and medical history need to be considered.
Key Findings
- Combined oral contraceptives (COCs) increase the risk of venous thrombosis compared to non-use, with a relative risk of 3.5 (95% confidence interval 2.9 to 4.3) 3.
- The risk of venous thrombosis is higher in women over 35 years old and those with a history of hypertension or smoking 2, 4, 5.
- Progestogen-only contraceptives (POCs) may be a safer option for women with multiple cardiovascular risk factors 2, 4.