How to Inject Repatha (Plus 4 More Pharmacist-Backed Tips)

Millions of people in the U.S. benefit from cholesterol medications. You’ve probably heard of statins and Zetia (ezetimibe); these are common once-daily pills that lower the risk of heart-related health complications. They’re widely available and accessible for those who need them.

Advertisements may have also introduced you to a newer medication — Repatha (evolocumab). It’s a FDA-approved proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor that’s reserved for people who can’t tolerate statins or aren’t benefiting from them as much as they should be. It can lower LDL (“bad”) cholesterol while also raising HDL (“good”) cholesterol — an ideal combination.

Repatha is an injectable medication that’s available in multiple formulations. It comes as a single-dose SureClick autoinjector, a prefilled syringe, and a hands-free device called a Pushtronex on-body infusor. This guide will provide step-by-step instructions on how to use each of these formulations.

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1. There are 3 spots to inject Repatha

Repatha should always be injected into the “fatty” tissue under your skin. The best spots to inject it are the stomach, upper thigh, or upper arms.

If you plan to give yourself your injections, the stomach and upper thigh are the best spots. Between the two, many people prefer the stomach for convenience’s sake. Some believe it hurts less, too. If you inject the medication in the stomach, just make sure it’s at least 2 inches away from your belly button.

If you choose to administer Repatha in your upper arms, it’s recommended to have someone else do the injection for you. It’s hard to give yourself an injection in your upper arm because of the awkward angle.

Good to know: You can inject each dose into the same body part if you want. But it’s important to rotate the specific patch of skin that you inject it in. This helps prevent irritation and other injection site reactions. Also make sure to avoid areas of skin that are cut, bruised, or scarred.

2. Injecting Repatha is a step-by-step process

To properly inject Repatha, there are a number of steps involved. Some steps are the same regardless of which product you’re using to administer your Repatha dose. Other steps are specific to which product you’re using. We break down each step below.

Getting started

Before you inject your dose of Repatha, you will want to make sure you’re organized with your materials and understand how to use your product. Some primary steps you can take to prepare for your injection include:

• Learn about your device: Review your package’s instructions for use and talk to a healthcare provider if you have any questions.

• Gather your supplies: Once you find a clean workplace, collect your materials, including your Repatha device, an alcohol swab, cotton pad, bandage, and sharps container. 

• Wash your hands: Use soap and water and scrub your hands for at least 20 seconds. If you don’t have access to soap and water, hand sanitizer is an acceptable backup option.

• Examine your device: Check the expiration date on your Repatha device and look for any cracks or breaks. Don’t use the device if it looks broken or any part is missing. Also make sure the fluid is clear — don’t use it if it appears cloudy or has particles in it.

• Prepare the injection site: First, clean your injection site with an alcohol swab. Let it dry naturally (without blowing or touching the area) before injecting your dose.

Injecting your medication

These next steps will depend on which product you’re using to administer your dose.

SureClick autoinjector

To prepare for the injection, you’ll first need to remove the orange cap on the SureClick autoinjector. You have 5 minutes to inject your dose after removing this cap. Otherwise, the medication may dry out and the injection might not be successful.

Now you’re ready to inject the medication. First, pinch together a 2-inch area of skin. Then, place the autoinjector at a 90-degree angle on your skin while keeping your skin pinched. Then press the gray button to start the injection. You will hear a click. Keep pushing the gray button down for 15 seconds. Check the window on the pen to see it start moving as the medication is delivered. Once the injection is completed, the window should be completely yellow. You may hear another click at this point when it’s done. You won’t ever see a needle.

Pre-filled syringe

When using a pre-filled syringe, you’ll first want to remove the gray cap and be careful not to touch the needle. Then, you’ll pinch together a 2-inch area of skin. Then, inject the syringe at a 45- to 90-degree angle into your skin while keeping your skin pinched. Use a slow, constant pressure and push the plunger all the way down until the syringe is empty. Once you have pushed all the way, lift your thumb off the plunger and remove the syringe. Do not put the gray needle cap back on the syringe.

Pushtronex on-body infusor

To prep the Pushtronex on-body infusor, first open the cartridge door and keep it open. Clean the bottom of the cartridge with an alcohol swab. Load the cartridge bottom first into the on-body infusor and push it straight down so it’s secure. You have 5 minutes to inject your dose after loading the cartridge. Close the cartridge door, making sure you hear a snap sound when you close it. Remove both green pull tabs when you’re ready — this activates a beeping sound and flashing lights.

At this point, you should stretch your skin so the device can lay flat. Then, place the device on your desired injection site. Secure the adhesive edges to your skin with your finger. You will see a blue light indicating that it’s ready. Firmly press and release the button. You should see a flashing green light and hear a click, which means delivery of the medication has started. The entire process of delivering the medication should take 5 minutes. 

After it’s complete, you will hear the device beep several times and the status light turn a solid green. When it is finished, grab the edge of the adhesive and peel it off your skin. You don’t ever see a needle with this device either.

Final steps

Once you’ve successfully administered your dose of Repatha, you will need to discard your device — regardless of which product you used — in a sharps container. You should never put the device into the regular trash or recycle bin. Repatha devices aren’t designed to be reusable. 

Following the injection, you’ll want to keep an eye on the injection site. If you notice any blood after your injection, press a cotton pad against your skin or put on a bandage. And don’t be alarmed if this happens — this is completely normal.

3. You’ll only need to administer Repatha every few weeks

Repatha is usually administered every few weeks — not every day.

Generally, you’ll inject the SureClick autoinjector or prefilled syringe every 2 weeks. The Pushtronex on-body infusor is usually used every 4 weeks. Your healthcare provider will tell you how often you should administer your doses.

It doesn’t really matter if you inject your doses in the morning, afternoon, or evening. But it’s important to stick to the day when your dose is scheduled. Talk to your healthcare provider if you missed a dose or need to change the day you inject Repatha.

4. Storing Repatha correctly can prolong its shelf life

Keep your unused Repatha in its original container. This container is designed to protect the medication against environmental damage, so it’s best to avoid transferring it.

Try to store unused Repatha devices in the fridge (36°F to 46°F), too. Refrigerating it makes sure the medication lasts until its labeled expiration date. Once you remove Repatha from the fridge, you should use it within 30 days.

5. Injecting Repatha doesn’t have to be too painful

Many people find Repatha injections to be relatively painless. But if you do experience pain, there are a few steps you can take to lessen it.

The first thing to try takes place while you’re preparing your dose. You can remove your Repatha device from the fridge about 30 to 45 minutes before each injection. An injection that’s at room temperature stings less than one that’s very cold. But allow it to come to room temperature naturally — do not quickly warm up the medication with a microwave or hot water.

Also, make sure to choose an injection site that isn’t bruised, broken, or scarred. Rotating which site you choose helps prevent pain. You can also ice the injection site after each dose to numb the affected area of skin.

As you get used to the process of injecting Repatha, you’ll likely be able to tolerate the medication better with every dose. But make sure to discuss with your healthcare provider if you continue to feel pain.

Tips for saving money on your Repatha prescription

There are ways to save on Repatha. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $5 for Repatha using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Repatha’s patient assistance program, which offers the medication free of charge.

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Written by:

Hindu Rao, PharmD, APh, BCACP

Hindu Rao, PharmD, APh, BCACP is a clinical assistant professor of pharmacy practice at Chapman University School of Pharmacy and a clinical pharmacist at Providence Medical Foundation. She specializes in chronic disease management and has her board certification in ambulatory care.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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