Management of Muscle-Related Adverse Effects with Repatha

Assessment and Management of Muscle Pain

• For patients on Repatha with mild muscle pain without elevated creatine kinase (CK) levels, the American College of Cardiology recommends continuing Repatha, considering acetaminophen or NSAIDs for pain relief if no contraindications, and monitoring symptoms 1
• In cases of moderate muscle pain or mildly elevated CK, consideration should be given to temporary interruption of Repatha, assessing for other contributing factors, ruling out other causes of myalgia, and considering rechallenge after symptoms resolve 1
• For severe muscle pain or significantly elevated CK, the guideline recommends discontinuing Repatha, considering referral to rheumatology or neurology, and evaluating for alternative lipid-lowering strategies 1

Distinguishing from Statin-Induced Myopathy

• The American College of Cardiology notes that statin-induced myopathy is more common and well-documented, and it's essential to determine which drug is causing the symptoms in patients taking both statins and Repatha 2

Concomitant Statin Therapy and Drug Interactions

• Patients taking both statins and Repatha may have an increased risk of muscle symptoms, and it's crucial to consider whether symptoms began after adding Repatha to existing statin therapy, with the American College of Cardiology providing guidance on managing such cases 2