Mipomersen

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Mipomersen Brand Name– Kynamro

What is Mipomersen

Mipomersen an injection administered once weekly, is the first apolipoprotein B (apo B) synthesis inhibitor approved to reduce cholesterol concentrations in patients with homozygous familial hypercholesterolemia (HoFH).

As an adjunct to diet and other medications used to treat hypercholesterolemia, mipomersen further reduces low-density lipoprotein-cholesterol (LDL-C), apo B, total cholesterol, and non-high density lipoprotein-cholesterol (non HDL-C).

Mipomersen (Kynamro) was FDA-approved in January 2013.

Indications

  • homozygous familial hypercholesterolemia

For the reduction of 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)

NOTE: Mipomersen is indicated for use as an adjunct to a low-fat diet and in combination with other lipid-lowering medications. The safety and efficacy of mipomersen as an adjunct to LDL apheresis has not been established and is therefore not recommended.

Side Effects

  1. abdominal pain
  2. angina
  3. angioedema
  4. antibody formation
  5. chills
  6. elevated hepatic enzymes
  7. elevated hepatic enzymes
  8. erythema
  9. fatigue
  10. fever
  11. glomerulonephritis
  12. headache
  13. hematoma
  14. hepatotoxicity
  15. hypertension
  16. influenza
  17. injection site reaction
  18. insomnia
  19. musculoskeletal pain
  20. nausea
  21. new primary malignancy
  22. palpitations
  23. peripheral edema
  24. proteinuria
  25. pruritus
  26. rash
  27. skin discoloration
  28. steatosis
  29. thrombocytopenia
  30. urticaria
  31. vomiting

Monitoring Parameters

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

Contraindications

  • breast-feeding
  • contraception requirements
  • dialysis
  • ethanol ingestion
  • geriatric
  • hepatic disease
  • hepatotoxicity
  • low-density lipoprotein apheresis
  • pregnancy
  • proteinuria
  • renal impairment
  • reproductive risk

Interactions

  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Amiodarone
  • Benzhydrocodone; Acetaminophen
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Demeclocycline
  • Doxycycline
  • Ethanol
  • Isotretinoin
  • Lomitapide
  • Methotrexate
  • Minocycline
  • Omadacycline
  • Sarecycline
  • Tetracycline
  • Tetracyclines

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