Composition
Cap 2.5mg/5mg/10mg/15mg: Mavacamten 2.5mg/5mg/10mg/15mg
Indications & Dosage
Symptomatic Obstructive Hypertrophic Cardiomyopathy (oHCM) to improve functional capacity and symptoms: Adult: Recommended starting dose is 5 mg orally once daily. Titration: Dose range from 2.5 mg – 15 mg once daily, adjust every 4 weeks based on echocardiography (LVEF, LVOT gradient). The maximum dose is 15 mg orally once daily. Dose must be individualized, consider temporarily stop if LVEF < 50%.
Contraindications
Concomitant use of strong CYP2C19, moderate to strong CYP2C19 inducers or moderate to strong CYP3A4 inducers
Precautions
Risk of heart failure or significantly reduce ventricular function. Severe hepatic impairment (Child-Pugh C) monitor prior to and at monthly intervals during therapy. Embryo-Fetal Toxicity; women of childbearing potential should use non-hormonal contraception during treatment; perform monthly pregnancy test where appropriate. Avoid abrupt withdrawal; withdraw treatment gradually.
Interactions
CYP3A4 inhibitors and CYP3A4 inducers, CYP2C19 inhibitors and inducers, contraceptives, cyclosporin, rifampicin, glibenclamide, tacrolimus, sirolimus, sildenafil, simvastatin.
Pregnancy
Contraindicated in pregnancy
Lactation
Not recommended.
Side Effects
Heart failure, diarrhea, flushing, headache, hypotension, oedema, palpitation, syncope, leucopenia, neutropenia, thrombocytopenia, dyspnoea, GI upset, erythema. Rare: Liver cirrhosis.