evolocumab at a glance
Medicine class
PCSK9 inhibitor monoclonal antibody
Administration
Injection under the skin using a single-use pre-filled pen
Injection sites
Abdomen, thigh or upper arm; rotate sites and avoid sore, bruised, red or hard skin
Storage
Keep refrigerated, protected from light and do not freeze
What is evolocumab used for?
Licensed uses include:
Primary hypercholesterolaemia or mixed dyslipidaemia in adults, alongside diet.
Heterozygous familial hypercholesterolaemia in people aged 10 years and over, alongside diet.
Homozygous familial hypercholesterolaemia in adults and people aged 10 years and over, with other lipid-lowering therapies.
Reducing cardiovascular risk in adults with established atherosclerotic cardiovascular disease, such as previous myocardial infarction, stroke or peripheral arterial disease.
How does evolocumab work?
PCSK9 normally promotes the breakdown of LDL receptors on liver cells. Evolocumab blocks PCSK9, leaving more receptors available to remove LDL cholesterol from the blood.
How to take evolocumab
Use only after a healthcare professional has demonstrated the injection technique. Inject under the skin and rotate suitable injection sites.
Let the pen reach room temperature naturally; do not heat or shake it.
Check that the solution is clear to opalescent and colourless to yellowish. Do not use it if cloudy, discoloured or visibly particulate.
Do not inject into tender, bruised, red or hard skin.
Put the single-use pen into an appropriate sharps container after use.
Continue the prescribed cholesterol-lowering diet and other treatments.
evolocumab side effects
Common or expected effects
- Cold or upper-respiratory symptoms, including sore throat or runny nose
- Influenza
- Back, joint or muscle pain
- Injection-site bruising, redness, bleeding, pain or swelling
- Headache
- Nausea
- Rash or other hypersensitivity reactions
Get urgent medical advice
- Swelling of the face, mouth, tongue or throat, especially with difficulty breathing or swallowing
- Other rapidly developing symptoms of a severe allergic reaction
evolocumab in pregnancy
Human pregnancy data are limited. Evolocumab should generally not be used during pregnancy unless the woman's clinical condition requires it. Discuss treatment with the specialist or prescriber when planning pregnancy or after becoming pregnant.
evolocumab while breastfeeding
It is unknown whether evolocumab passes into human milk, and risk to a breastfed infant cannot be excluded. The prescriber should weigh the importance of treatment against the benefits of breastfeeding.
evolocumab interactions
Formal interaction evidence is limited. Tell the prescribing team about all medicines and supplements.
Statins
Statins modestly increase evolocumab clearance, but this has not adversely affected its lipid-lowering action. No statin adjustment is required specifically because of evolocumab.
Common questions about evolocumab
Answers are fully visible for fast scanning and source review.
Is evolocumab a statin?
No. It is an injectable monoclonal antibody that blocks PCSK9.
Can it be used when statins are not tolerated?
Yes. Its licence includes use alone or with other lipid-lowering treatment when a statin is not tolerated or is contraindicated.
Does it replace a cholesterol-lowering diet?
No. It is used alongside a cholesterol-lowering diet and appropriate management of other cardiovascular risk factors.
Can I inject it myself?
Self-injection is possible after appropriate training. A trained caregiver may also administer it.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.