Who Can Prescribe Repatha (Evolocumab)
Any licensed physician, nurse practitioner, or physician assistant with prescribing authority can prescribe Repatha (evolocumab), as it does not require special certification, REMS enrollment, or restricted prescriber status.
Prescriber Requirements
No special training or certification is required to prescribe Repatha, unlike certain controlled substances or medications with Risk Evaluation and Mitigation Strategies (REMS) programs 1, 2.
Licensed healthcare providers with prescribing authority include physicians (MDs and DOs), nurse practitioners (NPs), and physician assistants (PAs) who can legally prescribe medications in their jurisdiction 3.
Specialists who commonly prescribe Repatha include cardiologists, endocrinologists, lipidologists, and primary care physicians managing patients with hypercholesterolemia 4, 5.
Clinical Context for Prescribing
Repatha is FDA-approved for:
Adults with primary hypercholesterolemia (heterozygous familial and non-familial) or mixed dyslipidemia as an adjunct to diet, with or without a statin and/or other lipid-lowering therapies 5.
Adults and adolescents aged ≥12 years with homozygous familial hypercholesterolemia in combination with other lipid-lowering therapies 5, 6.
Patients whose LDL-cholesterol has not been adequately controlled by statins and other therapies 2, 4.
Administration Details
Repatha is administered subcutaneously at a dosage of 140 mg every 2 weeks or 420 mg once monthly 4, 6.
The medication can be prescribed for self-administration by patients or administered in clinical settings 6.
Important Prescribing Considerations
Contraindications and precautions:
Do not use on wounds or damaged skin 1.
Do not use in children under 12 years old without consulting a physician (except for homozygous familial hypercholesterolemia where it is approved for ages ≥12 years) 1, 5.
Avoid if the patient is allergic to any ingredients in the product 1.
Monitoring for adverse effects:
While generally well-tolerated, rare psychiatric side effects including mood disturbances have been reported and should be monitored 7.
Mental health outcomes should be assessed, particularly in patients experiencing significant LDL-cholesterol reduction 7.
Practical Prescribing Algorithm
Verify prescriber credentials: Confirm you have active prescribing authority in your jurisdiction 3.
Assess patient eligibility: Confirm diagnosis of hypercholesterolemia (familial or non-familial) and inadequate response to statins or statin intolerance 4, 5.
Check contraindications: Review allergy history and ensure patient is ≥12 years old if treating homozygous familial hypercholesterolemia 1, 5.
Write prescription: Specify either 140 mg every 2 weeks or 420 mg monthly subcutaneous administration 4, 6.
Provide patient education: Instruct on proper subcutaneous injection technique and storage 6.
Monitor response: Assess LDL-cholesterol reduction and screen for mood changes or other adverse effects 4, 7.