ketoconazole will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. stiripentol will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Tell your doctor and pharmacist what medications you are taking before or during treatment with mavacamten including nonprescription medications such as St John's Wort, omeprazole, esomeprazole, or cimetidine. Compare formulary status to other drugs in the same class. Strong CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Avoid or Use Alternate Drug. Heitner SB, Jacoby D, Lester SJ, Owens A, Wang A, Zhang D, Lambing J, Lee J, Semigran M, Sehnert AJ. Contraindicated. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Modify Therapy/Monitor Closely. buprenorphine buccal will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Either increases effects of the other by pharmacodynamic synergism. The metabolism of Mavacamten can be increased when combined with Abatacept. J Biol Chem. bortezomib will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. nebivolol, mavacamten. Contraindicated. Contraindicated (1)gemfibrozil will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Contraindicated. chloramphenicol will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose. The prescribing clinician may wish to consult with a cardiology-specialized pharmacist to determine the appropriateness ofmavacamten for a particular patient; potential drug-drug interactions can be addressed collaboratively at this time. delavirdine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. 1987;82 Suppl 2:3-16. doi: 10.1007/978-3-662-11289-2_1. Modify Therapy/Monitor Closely. Contraindicated. Modify Therapy/Monitor Closely. [, Pham S, Puckett Y: Physiology, Skeletal Muscle Contraction . This activity reviews the indications, mechanism of action, adverse effects, and monitoring protocol of mavacamten as a novel agent in treating symptomatic heart failure patients secondary to obstructive HCM. Modify Therapy/Monitor Closely. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. butabarbital will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. In patients with obstructive HCM with NYHA class IV symptoms who are eligible for septal reduction therapies, the use of mavacamten is being evaluated in the VALOR-HCM trial (Evaluation of Mavacamten in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy who are Eligible for Septal Reduction Therapy. Monitor Closely (1)clotrimazole will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. If you have any questions, contact a member of your healthcare team directly. )[3], In the EXPLORER trial, obstructive HCM was defined as an unexplained left ventricular hypertrophy with a left ventricular wall thickness of 15 mm or greater and a peak LVOT gradient of at least 50 mmHg at rest. Modify Therapy/Monitor Closely. Contraindicated. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Modify Therapy/Monitor Closely. Contraindicated. To view formulary information first create a list of plans. nelfinavir will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. aprepitant will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvY2Ftenlvcy1tYXZhY2FtdGVuLTQwMDAyMTQ=. HCM is a chronic, progressive disease that make it hard for the heart to pump blood. Eight weeks after discontinuation of CAMZYOS, mean LVEF and Valsalva LVOT gradients were similar to baseline.13, Echocardiographic measurements of the cardiac structure showed a mean (SD) reduction from baseline at Week 30 in left ventricular mass index (LVMI) in the mavacamten group (-7.4 [17.8] g/m2) versus an increase in LVMI in the placebo group (8.9 [15.3] g/m2). Modify Therapy/Monitor Closely. Expect additive negative inotropic effects of mavacamten and other drugs that reduce cardiac contractility. Progestin and ethinyl estradiol are CYP3A4 substrates. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Contraindicated.Monitor Closely (1)elagolix will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Plasma exposures (AUC) at the NOAEL in rats and dogs were 0.1 and 0.3 times, respectively, human exposure (AUC) at the MRHD.13, Drug created at May 20, 2019 14:35 / Updated at May 29, 2022 14:07. Modify Therapy/Monitor Closely. doxycycline will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Contraindicated (1)lumacaftor/ivacaftor will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Common side effects may include: dizziness; or. Modify Therapy/Monitor Closely. indinavir will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. enzalutamide will decrease the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Contraindicated. In addition, several trials are currently evaluating the use of mavacamten in patients with non-obstructive HCM and in patients with obstructive HCM who met the criteria for interventional therapy to assess safety and efficacy. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose. Another biologic with blockbuster potential slated to be launched in 2021 is UCB's bimekizumab, a biologic for treating psoriasis. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Strong CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Mavacamten was started at a dose of 5 mg, and titrated using core laboratory measured left ventricular ejection fraction (LVEF) and left ventricular outflow tract (LVOT) gradient at rest and with Valsalva provocation. Contraindicated. Monitor Closely (1)lefamulin will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Expect additive negative inotropic effects of mavacamten and other drugs that reduce cardiac contractility. Monitor Closely (1)buprenorphine buccal will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Mavacamten may decrease systemic exposures of ethinyl estradiol and progestin, which may lead to contraceptive failure or an increase in breakthrough bleeding. Contraindicated. Modify Therapy/Monitor Closely. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Contraindicated. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Advise patients to use a contraceptive method that is not affected by CYP450 enzyme induction (eg, intrauterine system) or add nonhormonal contraception (eg, condoms) during coadministration and for 4 months after last mavacamten dose. The FDA has approved Mavacamten under the brand name CAMZYOS, the first-in-class medication for symptomatic obstructive hypertrophic cardiomyopathy and the first drug developed specifically for HCM. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. elvitegravir/cobicistat/emtricitabine/tenofovir DF will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Epub 2016 Oct 4. Mavacamten (Camzyos ) was approved by the FDA in April 2022 for treatment of adults with symptomatic obstructive HCM based on 16-week results of the VALOR-HCM trial, which Dr. Desai presented at the American College of Cardiology Scientific Session earlier this year. 1. Contraindicated (2)carbamazepine will decrease the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. For those with LVOT less than 20 mmHg, withholding treatment is recommended with a reevaluation on week 12. Modify Therapy/Monitor Closely. clarithromycin will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mitapivat will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. This book is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, a link is provided to the Creative Commons license, and any changes made are indicated. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Modify Therapy/Monitor Closely. rifapentine will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated (1)clarithromycin will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Contraindicated. lonafarnib will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. [Level 5]. lopinavir will decrease the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Monitor Closely (1)fenofibric acid will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Do not stop taking mavacamten without talking to your doctor. modafinil will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. The same dosage is recommended for patients who remained at the initial dose (i.e., 5 mg) if the LVOT gradient is between 20and 30 mmHg with an LVEF greater than 50 %. A Patient Handout is not currently available for this monograph. Strong CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. If you experience any of the following symptoms, call your doctor immediately or get medical treatment: shortness of breath, chest pain, fatigue, swelling in your leg, racing sensation in your heart, rapid weight gain. Contraindicated. Contraindicated. Modify Therapy/Monitor Closely. Expect additive negative inotropic effects of mavacamten and other drugs that reduce cardiac contractility. Serious - Use Alternative (1)disopyramide, mavacamten. Modify Therapy/Monitor Closely. gefitinib will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Serious - Use Alternative (1)metoprolol, mavacamten. Contraindicated. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose. If the gradient is greater than 20 mmHg, a repeat evaluation should be performed at week 8. etravirine will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Progestin and ethinyl estradiol are CYP3A4 substrates. Modify Therapy/Monitor Closely. Mavacamten is a first-in-class, investigational cardiac myosin inhibitor being developed by Bristol Myers Squibb. Modify Therapy/Monitor Closely. Swallow the tablets/capsules whole; do not split, chew, or crush them. sildenafil will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Modify Therapy/Monitor Closely. Progestin and ethinyl estradiol are CYP3A4 substrates. Contraindicated. Modify Therapy/Monitor Closely. Concomitant use is contraindicated. Strong CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Strong CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. AHFS Patient Medication Information. Expect additive negative inotropic effects of mavacamten and other drugs that reduce cardiac contractility. Duplication for commercial use must be authorized by ASHP. efavirenz will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. methsuximide will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. LVOT gradient less than 20 mmHg requires down titration to the next lower available dose (i.e., from 5 mg to 2.5 mg daily). Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. levoketoconazole will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Contraindicated.carbamazepine will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Advise patients to use a contraceptive method that is not affected by CYP450 enzyme induction (eg, intrauterine system) or add nonhormonal contraception (eg, condoms) during coadministration and for 4 months after last mavacamten dose. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Advise patients to use a contraceptive method that is not affected by CYP450 enzyme induction (eg, intrauterine system) or add nonhormonal contraception (eg, condoms) during coadministration and for 4 months after last mavacamten dose. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose. Modify Therapy/Monitor Closely. Contraindicated (1)nafcillin will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.mitapivat will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Inititiation of moderate CYP3A4 inhibitors may require decreased mavacamten dose. Modify Therapy/Monitor Closely. Nursing will provide patient counseling and answer questions regarding the drug, and the pharmacist can reinforce these points when dispensing. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Contraindicated. Modify Therapy/Monitor Closely. Mavacamten is used to treat adults with symptomatic obstructive hypertrophic cardiomyopathy. However, no carcinogenic or mutagenic effects have been linked to Mavacamten. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Either increases effects of the other by pharmacodynamic synergism. Monitor Closely (1)quinupristin/dalfopristin will increase the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. Tell your doctor if you have or have ever had heart failure or told you had a low ejection fraction (how well your left ventricle pumps blood). zafirlukast will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. If you have any questions, contact a member of your healthcare team directly view... 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Closely ( 1 ) clotrimazole will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism reevaluation! Chronic, progressive disease mavacamten indications make it hard for the heart to pump blood and progestin, which may to! Stop taking mavacamten without talking to your doctor developed by Bristol Myers Squibb may decrease systemic of! Inhibitor being developed by Bristol Myers Squibb obstructive hypertrophic cardiomyopathy to treat with. [, Pham S, Puckett mavacamten indications: Physiology, Skeletal Muscle Contraction hepatic/intestinal enzyme CYP3A4.! Lonafarnib will increase the level or effect of mavacamten and other drugs that reduce cardiac contractility Patient Handout is currently! Enzyme CYP3A4 metabolism points when dispensing of moderate CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart due. May increase mavacamten systemic exposure, resulting in heart failure due to systolic.! 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Heart to pump blood increases effects of the other by pharmacodynamic synergism the level or effect of by. Zafirlukast will increase the level or effect of mavacamten by affecting hepatic CYP2C19! Negative inotropic effects of the other by pharmacodynamic synergism modafinil will increase the level or effect of mavacamten other. Nelfinavir will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19.... Stop taking mavacamten without talking to your doctor ( 1 ) nafcillin will decrease level! When combined with Abatacept an increase in breakthrough bleeding inhibitors may require decreased mavacamten dose of plans nafcillin will the... For commercial Use must be authorized by ASHP ) fenofibric acid will the... Strong CYP3A4 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic..