Zocor vs. Repatha
See how Zocor and Repatha compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Zocor is a low-cost oral statin taken once a day, while Repatha is an injectable antibody given every two weeks or once a month.
Repatha produces larger LDL reductions than statins and has no boxed warning, but its list price is far higher than generic Zocor.
Both drugs are approved to lower cardiovascular risk, and doctors often add Repatha when a statin alone does not lower LDL enough.
Zocor vs. Repatha Drug Summary
Zocor
Zocor (simvastatin) is a statin that lowers LDL cholesterol by blocking an enzyme the liver uses to make cholesterol. It is taken as a once-daily oral tablet and has been used since 1991 to treat high cholesterol and reduce cardiovascular risk.
Repatha
Repatha (evolocumab) is a PCSK9 inhibitor, a lab-made antibody that helps the liver clear more LDL cholesterol from the blood. It is given as a subcutaneous injection every two weeks or once a month, usually alongside a statin or when statins are not enough.
Zocor vs. Repatha Side Effects
Zocor
Repatha
Zocor vs. Repatha Dosage
Zocor
Repatha
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 80 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 140 mg every 2 weeks | At the start |
| Maximum dose | 420 mg every 2 weeks | If needed |
| Dose changes | 2 increases | As tolerated |
Zocor
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 80 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Repatha
| STAGE | DOSE | WHEN |
| Starting dose | 140 mg every 2 weeks | At the start |
| Maximum dose | 420 mg every 2 weeks | If needed |
| Dose changes | 2 increases | As tolerated |
Zocor vs. Repatha Indications
Zocor
Zocor is FDA-approved to lower LDL cholesterol in adults with high cholesterol, including inherited forms like familial hypercholesterolemia. It is also approved to reduce the risk of heart attack, stroke, and death in people with existing heart disease or diabetes at high cardiovascular risk.
Lowers LDL cholesterol in primary hyperlipidemia
Treats heterozygous familial hypercholesterolemia (ages 10+)
Adjunct therapy for homozygous familial hypercholesterolemia
Reduces heart attack, stroke, and death risk in high-risk adults
Repatha
Repatha is FDA-approved to lower LDL cholesterol in adults and children 10 and older with familial hypercholesterolemia, usually alongside a statin or other LDL-lowering therapy. It is also approved to reduce the risk of heart attack, stroke, and certain heart surgeries in adults with established cardiovascular disease.
Lowers LDL cholesterol in heterozygous familial hypercholesterolemia (ages 10+)
Lowers LDL cholesterol in homozygous familial hypercholesterolemia (ages 10+)
Reduces heart attack and stroke risk in established cardiovascular disease
Used as add-on to statins or other LDL-lowering therapy
Zocor vs. Repatha Pros and Cons
Zocor
Zocor has decades of real-world safety data and is available as an inexpensive generic that most insurance plans cover easily. Its main risks are muscle-related side effects and interactions with certain other medications, which require some caution with dosing.
Pros
Low-cost generic, roughly $75 to $100 per month
Once-daily oral tablet, no injections needed
Decades of clinical experience since 1991
Widely covered by insurance with low copays
Cons
Risk of myopathy and rhabdomyolysis, especially at 80 mg
Contraindicated with strong CYP3A4 inhibitors
Contraindicated in pregnancy
Generally smaller LDL reductions than PCSK9 inhibitors
Repatha
Repatha offers larger LDL reductions than statins alone and carries no boxed warning, but it must be injected rather than taken as a pill. Its high list price and lack of a biosimilar competitor make cost a bigger barrier for many patients.
Pros
No boxed warning on the label
Larger LDL reductions than statins alone
Dosing as infrequent as once monthly
Fully human antibody with low drug-interaction risk
Cons
Roughly $580 to $730 per month without insurance
Requires injection every 2 weeks or monthly
No biosimilar competition to lower price as of 2026
Needle cover contains latex, a risk for allergic patients
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