Update 7/24/20. Repatha (evolocumab) is a popular medication for those with high LDL cholesterol levels. Another drug is called Praluent (alirocumab). Both medications are technically called PCSK9 inhibitors (more about that below). These drugs work differently than statins and have the advantage of only needing to be used once or twice a month. Muscle pain (myalgia) is a side effect statins but what about Repatha? Do PCSK9 inhibitors cause muscle pain too? I became interested after someone I know who takes Repatha said he was experiencing muscle pain. So does it? Let's look at the research and see what we can discover. See the Earlobe Crease And Heart Disease review.
What Is Repatha?
Statin drugs work by targeting an enzyme (called HMG-CoA reductase) which helps make cholesterol. By blocking that enzyme, cholesterol levels decrease.
Repatha is not a statin medication (like Crestor, Lipitor, etc.) but rather, an antibody. Instead of targeting an enzyme, this antibody knocks out a protein that affects LDL receptors in the liver. By knocking out this protein (it's called PCSK9), LDL receptors are much better at removing LDL (bad cholesterol) from the blood. This, in turn, reduces the risk of atherosclerosis, heart attacks, and strokes.
Trivia: PCSK9 stands for proprotein convertase subtilisin kexin 9. Don't even try to pronounce it. Now you know why they call it PCSK9 🙂
Repatha and other PCSK9 inhibitors are injected with a small needle and are more powerful than statins drugs. They can be used in place of or in addition to statins. One big downside of PCSK9 inhibitors is that they are much more expensive than statin drugs. When I checked GoodRX.com, I saw Repatha selling for over $1200 for a month's supply! That's because the drugs are new.
As time goes by and generics become available, the cost will drop.
What Causes The Muscle Pain?
People who take cholesterol-lowering statins sometimes complain of muscle pain. This pain can range from flu-like muscle aches, called myalgia to more serious things like muscle damage, called rhabdomyolysis (rhabdo). While statistically, muscle pain from statins is supposed to be rare, almost everyone I meet who takes these drugs has complained of this problem. Take that for what it's worth, just my observation.
Because PCSK9 inhibitors work differently, they are not supposed to cause muscle pain.
But do they?
Repatha And Muscle Pain
This medication is sometimes given to people who cannot tolerate statin drugs due to muscle pain. Recently, someone I know who takes Rapatha every two weeks and complains of leg pain – and quite severe pain too. When asked to rate that pain on a scale from 1-10, he rated the pain as an “8.” Pretty intense. He said the pain goes away when he skips the drug for a week or so.
That made me wonder if muscle pain might also be a side effect of Repatha too.
The Pharmacy Times has an interesting review that discusses this. They note that in people who could not tolerate statin drugs, 12% of those receiving Repatha for 12 weeks reported muscle pain. The study can be found here.
Another study noted a 5.4% chance of myalgia in people taking Praluent (alirocumab). In a news release posted by Amgen, the maker of Repatha, noted muscle pain in 13.8% of people (it was lower than statin takers).
In a report from Amgen Canada, muscle pain has been reported in 3% of people using the drug
Bottom line: all this appears to show both Repatha and (Praluent) can cause muscle pain in some people. The percentage seems to be lower than with statins, but it still occurs.
Repatha Other Side Effects
While PCSK9 inhibitors have not been around as long as statins, common side effects reported can include:
|Back pain||Blurred vision||Body aches or pain|
|Ear congestion||Flushed or dry skin||Fruit-like breath odor|
|Headaches||Loss of voice||Sore throat|
|Stuffy or runny nose||Difficultly breathing||Vomiting|
|Weight loss||Skin discoloration||Sweating|
Some other things to be aware of:
- Some people have reported pain at the injection site
- Women who are pregnant should discuss the risk vs. benefits with their doctor before using it. There is a lack of research on this drug during pregnancy. The same thing goes if breastfeeding too.
- Approximately 1% to 10% of people taking this drug have reported high blood pressure. Monitor your blood pressure if you already have hypertension.
Homocysteine Levels: How To Lower It
Homocysteine is an amino acid linked to heart disease. If you were told your levels are high, here are 5 ways to reduce your levels
Can Supplements Help?
If your trying to lower cholesterol and LDL naturally, some supplements may help. For more insights see these reviews
- Apple Cider Vinegar (click to see review)
- Citrus Bergamot (click to see review)
- Cholesterol 360 Review (click to see review)
- Fiber (click to see review)
Natural PCSK9 Inhibitors?
Some evidence suggests the supplement, berberine might reduce PCSK9 naturally. the evidence is preliminary but it may be worth a try for those who don't want to take medications. For more insights see:
Obviously, results will vary. See the reviews for more on the research.
So Is Repatha Right For You?
Obviously, it depends on what your doctor thinks is best for you based on your individual health. These drugs are more common in those who don't respond well to statins. Price should also be considered as PCSK9 inhibitors can be very expensive. If you experience muscle pain, bring this up to your doctor. Remember, evidence suggests both Repatha and Praluent (Alirocumab) can cause muscle pain in some people so it may not be your imagination.