Référentiel des médicaments
Lomitapide
Lomitapide is a medicine in the class cardiovascular. It is used for hypercholesterolemia.
- Classe médicamenteuse: Cardiovascular
- Indications: hypercholesterolemia
Dernière mise à jour Sources: US FDA label, EMA SmPC
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L'essentiel
- Classe médicamenteuse
- Cardiovascular
- Code ATC
- C10AX12
- Formes courantes
- gélule
- Interactions connues
- 146 (Contre-indiquée: 16 · Majeure: 28 · Modérée: 68 · Mineure: 34)
- Noms commerciaux
- 2
- Pays et marchés
- 2
Indications
Mécanisme d'action
Binds and inhibits microsomal triglyceride transfer protein (MTP), preventing assembly of apo B-containing lipoproteins in enterocytes and hepatocytes. This inhibits chylomicron and VLDL synthesis and reduces plasma LDL-C.
Posologie adulte habituelle (résumé de la notice)
HoFH (18 years and older): start 5 mg orally once daily; titrate per Table 1 (weeks 0 to 2 at 5 mg, then 10 mg, 20 mg, 40 mg); maximum 60 mg daily from week 15, based on LDL-C target, safety and tolerability
Mode de prise habituel
Statins are taken by mouth once a day, long term, with blood tests to check the response and liver function.
Grossesse et allaitement
- Grossesse
- Unsafe Contraindicated in pregnancy; may cause fetal harm based on animal studies. Discontinue if pregnancy is detected.
- Allaitement
- Unsafe No data on presence in milk; breastfeeding is not recommended because of potential serious adverse reactions including hepatotoxicity.
Effets indésirables signalés
- Diarrhea
- Nausea
- Dyspepsia
- Abdominal pain
- Vomiting
- Chest pain
Mises en garde encadrées
- Risk of hepatotoxicity: can raise transaminases and increase hepatic fat (steatosis), a possible risk factor for steatohepatitis and cirrhosis. Measure ALT, AST, alkaline phosphatase and bilirubin before starting, then ALT and AST regularly. Adjust dose if ALT or AST ≥3 times ULN and discontinue for clinically significant liver toxicity. Available only through the JUXTAPID REMS Program. Prescribe only for HoFH.
Contre-indications
- Pregnancy
- Concomitant use with moderate or strong CYP3A4 inhibitors
- Moderate or severe hepatic impairment (Child-Pugh B or C) and active liver disease, including unexplained persistent transaminase elevations
Précautions particulières
- Hepatotoxicity: transaminase elevations and hepatic steatosis; monitor liver tests before each dose increase or monthly in the first year, then at least every 3 months
- Embryo-fetal toxicity: may cause fetal harm; negative pregnancy test before starting and effective contraception during treatment and for two weeks after
- Reduced absorption of fat-soluble vitamins and fatty acids; daily vitamin E and essential fatty acid supplements needed
Unexplained muscle pain, tenderness or weakness while taking a statin should be reported promptly. Statins are not used in pregnancy, and some other medicines raise their levels and risk.
Informez votre pharmacien ou votre médecin en cas de grossesse ou d'allaitement, de maladie rénale ou hépatique, d'allergies, ainsi que de tout autre médicament ou complément que vous prenez.
Principales interactions (146)
- Aprepitant + Lomitapide Contraindicated
- Clarithromycin + Lomitapide Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Efavirenz + Lomitapide Contraindicated
- Ensitrelvir + Lomitapide Contraindicated
- Erythromycin + Lomitapide Contraindicated
- Fluconazole + Lomitapide Contraindicated
- Imatinib + Lomitapide Contraindicated
- Itraconazole + Lomitapide Contraindicated
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- Dosing by age, kidney and liver function, and further dose lines
- Renal and hepatic dose adjustments
- Paediatric dosing
- Dosing in older adults
- How to give it
- Pharmacokinetics
- Patient counselling points
- Food interactions
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Questions fréquentes
What is Lomitapide used for?
Lomitapide is a medicine in the class cardiovascular. It is used for Hypercholesterolemia.
What side effects have been reported with Lomitapide?
Diarrhea, Nausea, Dyspepsia, Abdominal pain, Vomiting, Chest pain. Serious warning: Risk of hepatotoxicity: can raise transaminases and increase hepatic fat (steatosis), a possible risk factor for steatohepatitis and cirrhosis.
Can Lomitapide be taken in pregnancy or while breastfeeding?
Pregnancy: Unsafe. Contraindicated in pregnancy; may cause fetal harm based on animal studies. Discontinue if pregnancy is detected. Breastfeeding: Unsafe. No data on presence in milk; breastfeeding is not recommended because of potential serious adverse reactions including hepatotoxicity.
What does Lomitapide interact with?
MediHelp lists 146 known interactions for Lomitapide. Contraindicated: 16 · Major: 28 · Moderate: 68 · Minor: 34. The most serious include Aprepitant, Clarithromycin, Crizotinib.
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