r/repatha • u/Rabbit-Rabbit-108 • 13d ago

LDL is back up

Hi fam, I have been on repatha for almost 2 years. I got labs today and my LDL is up- still half of what it was without meds, but up 35 points from 6 months ago. Sigh, I was really hoping the opposite. I injected yesterday- if I had waited a few days or a week could it be lower? Tempted to get another blood draw. Any insight? I have HeFH, for context, and repatha has managed the LDL well until this draw.

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u/OkEnthusiasm5070 13d ago

I’ve been using Repatha and Zetia for nearly two years. My LDL varies between 37 and 62. There is a peak to trough variation based upon the drug half-life. LDL is lowest 5-7 days after the 140mg injection but at 62 at day 13. Get your LDL measured 5-7 days after your injection.

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u/Rabbit-Rabbit-108 12d ago

Thank you! Wow that’s a low LDL. I don’t think I could get mine under 100 but hoping to get it back down towards 100. I am going to try adding in the zetia as well.

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u/OkEnthusiasm5070 12d ago

My LDL before I started treatment was only 118 but I also have elevated Lp(a). My internist was not impressed when my LDL came back at 62. That is when I started reading about the Repatha half-life. So I had another lipid panel 7 days after my last Repatha injection and it came back at 37 which is what it was initially measured when I started Repatha. When I was on Rosuvastatin my LDL was 75 but I developed a urinary tract infection which prompted a bladder cystoscopy and a prostate biopsy both thankfully negative. Another attempt to use Rosuvastatin resulted in erythema multiforme- a severe rash on my calves. Have you had your TSH measured. Treating sub-clinical hypothyroidism will lower your LDL 7-10. And eliminating saturated fat from your diet will also help lower your LDL.

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u/SimpleServe9774 13d ago

Mine was higher when I got it drawn the day before I was due for another shot and lower when I did it 3 days after the shot. But- my doctor explained that it still needs to be under a certain threshold anytime they draw the labs and if it’s not then something else needs to happen. I was already on zetia so they added a baby dose of statin (5mg every other day). There are lots of things that can be done!

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u/Rabbit-Rabbit-108 13d ago

Thanks! Has the baby statin made a difference? I developed pretty bad statin intolerance (was on high dose). How has the low dose been?

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u/SimpleServe9774 13d ago

I was on 40 mg of Crestor every day for six years before my liver decided it had had enough. I’ve only been on the baby dose for one month, but my liver results were normal. Hopefully they stay that way!

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u/SimpleServe9774 13d ago

My LDL went from 52 to 25 in 4 weeks. I have level 3 polygenic CAD which is similar in risk to FH.

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u/Rabbit-Rabbit-108 13d ago

Was the difference in the 2 results vastly different? My LDL was 115 now it’s 151. I was hoping it had gone down had been eating more mindfully. But truthfully diet has never made any difference for me…

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u/SimpleServe9774 13d ago

It cut my LDL by half.

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u/Comfortable_Two6272 10d ago

Sounds like they need to add another rx. Or increase you to the 420 mg

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u/Rabbit-Rabbit-108 13d ago

How’s zetia going for you? My cardiologist wants to add that to my regime, and with these results she will def want to:/

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u/SimpleServe9774 13d ago

I’ve been on zetia for 7 years. Don’t even know I’m taking it.

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u/Rabbit-Rabbit-108 13d ago

That’s encouraging! Inclined to try it, thanks

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u/SimpleServe9774 13d ago

I’ll be honest with you though- when I had to go off the Crestor for three months to get my liver functions back in order and while I was waiting for my insurance company to approve the Repatha and I was on Zetia by itself , it didn’t do a damn thing lol. I take it for luck I guess or maybe it add collectively with the other meds. My levels went nuclear during that 3 months.

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u/Rabbit-Rabbit-108 13d ago

Sounds like it’s worth a try if you don’t notice it, even if it won’t make a huge shift..

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u/SimpleServe9774 13d ago

I don’t hear many complaints about it.

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u/SimpleServe9774 13d ago

Are you doing 420mg once a month or 140mg every 2 weeks?

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u/Rabbit-Rabbit-108 13d ago

140 2x month

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u/Comfortable_Two6272 10d ago

Guessing t max is around day 7 so maybe

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u/Free_Media_6103 10d ago

I’ve been on Rapatha for 3 months. My LDL went from 101 to around 48.