Short answer: The Repatha label dose for most adults and for children 10 and older with HeFH is 140 mg every 2 weeks or 420 mg once a month, injected under the skin. For HoFH it starts at 420 mg once a month and can go to 420 mg every 2 weeks after 12 weeks. The 420 mg dose is given as 3 injections within 30 minutes. A missed dose is taken within 7 days.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Repatha is approved for: Repatha is a PCSK9 inhibitor approved to lower the risk of major heart and blood vessel events (death from heart disease, heart attack, stroke, unstable angina needing a hospital stay, or procedures to restore blood flow) in adults at increased risk, and, alongside diet and exercise, to lower LDL cholesterol in adults with high cholesterol and in adults and children 10 and older with heterozygous or homozygous familial hypercholesterolemia (HeFH or HoFH) (section 1).
Source
REPATHA (evolocumab) injection, for subcutaneous use, prescribing information, Patient Information and Instructions for Use. Amgen. DailyMed, version published October 23, 2026. DailyMed setid cd61e902-166d-4aa6-9f3c-a18c1008d07e
Repatha is injected under the skin of the abdomen, thigh or upper arm, rotating sites and avoiding skin that is tender, bruised, red, hard, scarred or stretch-marked (section 2.3).
Each pen, SureClick autoinjector or syringe holds 140 mg. The 420 mg dose is given as 3 injections in a row within 30 minutes (section 2.3). A refrigerated device is left at room temperature for at least 30 minutes before use.
Patients or caregivers are trained before injecting at home (section 2.3).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Who | Recommended dosage |
|---|---|
| Adults at increased risk for CV events or with hypercholesterolemia | 140 mg every 2 weeks OR 420 mg once monthly |
| Adults and pediatric patients aged 10 years and older with HeFH | 140 mg every 2 weeks OR 420 mg once monthly |
| Adults and pediatric patients aged 10 years and older with HoFH | Initially 420 mg once monthly; can be increased to 420 mg every 2 weeks if a clinically meaningful response is not achieved in 12 weeks |
| HoFH patients on lipid apheresis | May initiate treatment with 420 mg every 2 weeks to correspond with their apheresis schedule, given after the apheresis session is complete |
LDL cholesterol can be checked as early as 4 weeks after starting. On the 420 mg monthly dose, LDL can vary during the month, so the label recommends measuring it just before the next scheduled dose.
No dose change is needed for kidney impairment or mild to moderate liver impairment. There are no data in severe liver impairment (sections 8.6 and 8.7).
Repatha is refrigerated at 2 C to 8 C (36 F to 46 F) in the original carton, not frozen or shaken. It can be kept at room temperature, 68 F to 77 F, in the carton for 30 days, and is thrown away if not used in that time.
The label says, if a dose is missed: "Within 7 days from the missed dose, instruct the patient to administer REPATHA and resume the patient's original schedule. For an every 2-week dose, instruct the patient to wait until the next dose on the original schedule. For a once-monthly dose, instruct the patient to administer the dose and start a new schedule based on this date." The Patient Information makes clear the last two apply when it is more than 7 days from the missed dose.
More on this: missed a dose of Repatha.
When switching between the every-2-week and once-monthly regimens, the first dose of the new regimen is given on the next scheduled date of the old one.
In Dose Track you set up Repatha as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.