Lomitapide

Lomitapide Brand Name– Juxtapid

What is Lomitapide

Lomitapide is a microsomal triglyceride transfer protein (MTP) inhibitor that reduces low-density lipoprotein (LDL) cholesterol, total cholesterol, apolipoprotein B, and non-high-density lipoprotein (non-HDL) cholesterol in patients with homozygous familial hypercholesterolemia (HoFH), a rare genetic disorder in which the body cannot remove LDL cholesterol from the blood.

The safety and efficacy of lomitapide have not been established in patients with hypercholesterolemia who do not have HoFH. Lomitapide binds and inhibits MTP, which prevents the assembly of apo-B-containing lipoproteins and inhibits the synthesis of chylomicrons and VLDL.

Inhibiting the synthesis of VLDL ultimately leads to reduced concentrations of LDL cholesterol in the plasma.

Lomitapide is intended for use in combination with a low-fat diet and other lipid-lowering treatments.

Lomitapide has a boxed warning regarding potential hepatotoxicity.

Prescribers, pharmacies, and patients must certify/enroll in the Juxtapid REMs program. Regular liver monitoring is required before initiation of treatment and routinely during therapy.

More information is available at www.juxtapidREMSprogram.com.

Indications

  • homozygous familial hypercholesterolemia

For the reduction low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), apolipoprotein B (Apo-B), and non-high-density lipoprotein cholesterol (non-HDL-C) in patients with homozygous familial hypercholesterolemia (HoFH)

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. alopecia
  4. angina
  5. back pain
  6. chest pain (unspecified)
  7. constipation
  8. diarrhea
  9. diarrhea
  10. dizziness
  11. dyspepsia
  12. elevated hepatic enzymes
  13. elevated hepatic enzymes
  14. fatigue
  15. fever
  16. flatulence
  17. gastroesophageal reflux
  18. headache
  19. hepatotoxicity
  20. hypovitaminosis
  21. influenza
  22. myalgia
  23. nasal congestion
  24. nausea
  25. palpitations
  26. pharyngitis
  27. steatosis
  28. tenesmus
  29. vomiting
  30. vomiting
  31. weight loss

Monitoring Parameters

  • LFTs
  • serum alkaline phosphatase
  • serum bilirubin
  • serum cholesterol profile

Contraindications

  • breast-feeding
  • contraception requirements
  • dialysis
  • ethanol ingestion
  • hepatic disease
  • hepatotoxicity
  • lactase deficiency
  • malabsorption syndrome
  • pancreatic insufficiency
  • pregnancy
  • pregnancy testing
  • renal failure
  • renal impairment
  • reproductive risk
  • requires an experienced clinician

Interactions

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