From the Guidelines
Evolocumab injections commonly cause mild side effects including injection site reactions, cold-like symptoms, back pain, and muscle pain. The most common side effects of evolocumab injections are:
- Injection site reactions (redness, pain, or bruising)
- Cold-like symptoms
- Back pain
- Muscle pain More serious but less common side effects include allergic reactions (rash, itching, swelling, dizziness, or trouble breathing), which require immediate medical attention 1. Some patients may experience flu-like symptoms, joint pain, or headaches. Rarely, evolocumab can cause neurocognitive effects like confusion or memory problems. The medication works by blocking PCSK9 protein, allowing more LDL receptors to remain active on liver cells, which helps remove more LDL cholesterol from the bloodstream. Most side effects are temporary and resolve on their own, but patients should report persistent or severe symptoms to their healthcare provider. Proper injection technique can help minimize injection site reactions. Patients with latex allergies should be aware that the needle cover contains dry natural rubber, which could trigger allergic responses in sensitive individuals 1. It is essential to note that the benefits of evolocumab in reducing cardiovascular risk outweigh the potential side effects, and patients should discuss any concerns with their healthcare provider 1.
From the FDA Drug Label
Common (> 5% of patients treated with REPATHA and more frequently than placebo) adverse reactions in adults with: Primary hyperlipidemia: nasopharyngitis, upper respiratory tract infection, influenza, back pain, and injection site reactions. Established CVD: diabetes mellitus, nasopharyngitis and upper respiratory tract infection The most common side effects of REPATHA include: runny nose, sore throat, symptoms of the common cold, flu or flu-like symptoms, back pain, high blood sugar levels (diabetes) and redness, pain, or bruising at the injection site.
The side effects of evolocumab injections include:
- Common adverse reactions: nasopharyngitis, upper respiratory tract infection, influenza, back pain, and injection site reactions
- Established CVD: diabetes mellitus, nasopharyngitis, and upper respiratory tract infection
- Other common side effects: runny nose, sore throat, symptoms of the common cold, flu or flu-like symptoms, high blood sugar levels, and redness, pain, or bruising at the injection site 2, 2
From the Research
Side Effects of Evolocumab Injections
- The most common side effects of evolocumab injections include injection-site reactions, such as pain, redness, or swelling at the injection site 3, 4.
- Other potential side effects of evolocumab include:
- Allergies
- Myalgia (muscle pain)
- Poor blood glucose control
- Liver damage 4
- However, studies have shown that evolocumab is generally well-tolerated, with no significant difference in adverse events compared to placebo, except for injection-site reactions 3, 5.
- Long-term follow-up studies have also demonstrated that evolocumab has a favorable safety profile, with no apparent increase in adverse events, even at very low levels of LDL-C 5.
Cardiovascular Events and Safety
- Evolocumab has been shown to reduce the risk of major cardiovascular events, including cardiovascular death, myocardial infarction, and stroke, in patients with atherosclerotic cardiovascular disease 3, 5.
- The reduction in cardiovascular events was consistent across different patient subgroups, including those with high-risk profiles 3.
- The safety profile of evolocumab was also evaluated in patients with extremely high-risk acute coronary syndrome, and no increase in adverse reactions was observed compared to the control group 4.