What Is Juxtapid?
Juxtapid (lomitapide) is an oral prescription drug used to deal with a uncommon genetic situation known as homozygous familial hypercholesterolemia (HoFH), which causes very excessive ranges of LDL cholesterol. It’s obtainable as an oral capsule.
Juxtapid is in a drug class known as lipid-lowering brokers. Extra particularly, it’s a microsomal triglyceride switch protein (MTP) inhibitor. Juxtapid works by slowing down the physique’s manufacturing of ldl cholesterol. Nonetheless, it’s not identified if Juxtapid will decrease the danger of coronary heart assault, stroke, dying, or different well being issues.
Juxtapid shouldn’t be utilized in individuals who should not have HoFH.
Drug Details
Generic Identify: Lomitapide
Model Identify(s): Juxtapid
Administration Route(s): Oral
Drug Availability: Prescription
Therapeutic Classification: Antihyperlipidemic
Obtainable Generically: No
Managed Substance: N/A
Lively Ingredient: Lomitapide
Dosage Type(s): Capsule
What Is Juxtapid Used For?
The Meals and Drug Administration (FDA) authorized Juxtapid for use together with a low-fat food regimen and different therapies in adults with HoFH to decrease:
HoFH is a uncommon genetic situation that causes very excessive LDL ranges and may result in early cardiovascular occasions reminiscent of a coronary heart assault or stroke.
As a result of Juxtapid is related to liver toxicity, the drug is just obtainable by a restricted program known as the Juxtapid Threat Analysis and Mitigation Technique (REMS) program. Juxtapid can solely be prescribed by licensed healthcare suppliers enrolled in this system and may solely be distributed by licensed pharmacies which can be enrolled in this system. Juxtapid can solely be prescribed to adults with a analysis of HoFH who’re enrolled in this system and perceive the dangers and advantages.
Juxtapid shouldn’t be prescribed to folks with excessive ldl cholesterol who should not have HoFH.
Easy methods to Take Juxtapid
Learn the prescription label and the knowledge leaflet that comes together with your prescription. Seek the advice of your healthcare supplier when you’ve got any questions. Use Juxtapid precisely as directed by your supplier.
In case you are prescribed Juxtapid:
- Take Juxtapid as soon as each day with water, a minimum of two hours after the night meal. Don’t take Juxtapid with meals. Taking it with meals might trigger abdomen issues.
- Swallow the capsule complete. Don’t chew, crush, dissolve, or open the capsule. In the event you can not swallow the capsule complete, seek the advice of your healthcare supplier.
- In the event you take a ldl cholesterol medication that binds bile acids (for instance colesevelam or cholestyramine), take it a minimum of 4 hours earlier than or after Juxtapid.
- Eat a low-fat food regimen. This helps decrease the prospect of abdomen issues. Discuss to your healthcare supplier or a registered dietician to find out what you must eat whereas taking Juxtapid. You may additionally must take vitamin E and fatty acids whilst you take Juxtapid. Your healthcare supplier or dietician can information you on the right way to take these.
- Don’t cease taking Juxtapid until your healthcare supplier tells you to cease.
Ask your healthcare supplier when you’ve got any questions or issues about your treatment.
Storage
Retailer at room temperature, away from warmth, direct gentle, and moisture. Hold this treatment in its unique labeled container and out of the attain and out of sight of youngsters and pets. Hold the bottle tightly closed when not in use.
How Lengthy Does Juxtapid Take to Work?
Juxtapid might begin working immediately, however in some circumstances, the dosage might should be regularly elevated earlier than outcomes are seen. Your healthcare supplier will regulate your dose as wanted to achieve your ldl cholesterol objectives.
What Are the Facet Results of Juxtapid?
Like different medicines, Juxtapid may cause unwanted effects. Inform your healthcare supplier about any unwanted effects you expertise whereas taking this treatment.
This isn’t a whole record of unwanted effects and others might happen. A healthcare supplier can advise you on unwanted effects. In the event you expertise different results, contact your pharmacist or a healthcare supplier. It’s possible you’ll report unwanted effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Widespread Facet Results
The commonest unwanted effects of Juxtapid are:
- Abdomen issues: Abdomen ache, bloating, nausea, vomiting, diarrhea, indigestion, constipation, gasoline, abdomen “bug”, reflux (following a low-fat food regimen helps decrease the prospect of getting a few of these unwanted effects)
- Urgency or uncomfortable sensation of needing to have a bowel motion
- Weight reduction
- Chest ache
- Signs of the chilly or flu, reminiscent of throat ache or fever
- Tiredness
- Again ache
- Headache
- Dizziness
- Palpitations (feeling like the guts is racing, pounding, or fluttering)
- Elevated ranges of ALT or AST (exams of liver operate)
- Fatty liver disease
Extreme Facet Results
Name your healthcare supplier immediately when you’ve got critical unwanted effects. Name 911 in case your signs really feel life-threatening or in case you suppose you’re having a medical emergency. Critical unwanted effects and their signs can embody the next:
- Extreme vomiting
- Extreme diarrhea
- Liver toxicity
Lengthy-Time period Facet Results
Whereas many individuals tolerate Juxtapid effectively, long-term or delayed unwanted effects are doable. Some long-term unwanted effects might be gentle, reminiscent of:
- Weight reduction
- Flu
- Sore throat
- Again ache
- Feeling like that you must have a bowel motion (even when your bowels are empty)
- Reflux
- Hair loss
- Vitamin deficiency
Reasonable long-term unwanted effects can embody:
Extreme long-term unwanted effects might embody:
- Elevated liver enzyme ranges
- Liver toxicity
Dosage: How A lot Juxtapid Ought to I Take?
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The dose of this medication can be totally different for various sufferers. Comply with your physician’s orders or the instructions on the label. The next info consists of solely the typical doses of this medication. In case your dose is totally different, don’t change it until your physician tells you to take action.
The quantity of drugs that you simply take is determined by the energy of the medication. Additionally, the variety of doses you are taking every day, the time allowed between doses, and the size of time you are taking the medication rely upon the medical downside for which you might be utilizing the medication.
-
For oral dosage type (capsules):
-
For reducing unhealthy ldl cholesterol:
- Adults—At first, 5 milligrams (mg) as soon as a day. Your physician might regulate your dose as wanted and tolerated. Nonetheless, the dose is normally no more than 60 mg per day.
- Kids—Use and dose should be decided by your physician.
-
For reducing unhealthy ldl cholesterol:
Modifications
Your healthcare supplier may have to switch your remedy plan when you’ve got liver, coronary heart, or kidney issues. Individuals with kidney issues or gentle liver issues can use Juxtapid with warning and would require a decrease dosage. Nonetheless, folks with reasonable or extreme liver issues ought to by no means take Juxtapid.
Juxtapid ought to by no means be prescribed throughout being pregnant as a result of it may hurt the fetus. Breastfeeding can be not really useful throughout remedy with Juxtapid due to the opportunity of critical reactions, together with liver toxicity.
Ladies of childbearing age ought to have a unfavorable being pregnant check earlier than beginning Juxtapid. Use efficient contraception throughout your remedy and for 2 weeks after your last dose. You may seek the advice of your supplier in case you want steerage with contraception. In the event you take oral birth control pills, be aware that vomiting or diarrhea could make them much less efficient. When you’ve got these signs, use an efficient different technique of contraception till seven days after diarrhea or vomiting goes away.
In the event you already take Juxtapid and discover out that you’re pregnant, cease taking Juxtapid and name your healthcare supplier.
Missed Dose
In the event you miss a dose of Juxtapid, take the standard dose the following day, on the common time. In the event you cease taking Juxtapid for greater than seven days, seek the advice of your healthcare supplier earlier than restarting.
Overdose: What Occurs If I Take Too A lot Juxtapid?
In the event you take an excessive amount of Juxtapid, contact your healthcare supplier for the following steps. There isn’t a particular remedy for an overdose of this treatment. It’s possible you’ll be handled on your signs and require monitoring of liver-related exams.
What Occurs If I Overdose on Juxtapid?
In the event you suppose you or another person might have overdosed on Juxtapid, name a healthcare supplier or the Poison Management Heart (1-800-222-1222).
If somebody collapses or is not respiratory after taking Juxtapid, name 911 instantly.
Precautions
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It is rather vital that your physician test your progress at common visits. This can enable your physician to see if the medication is working correctly to decrease your unhealthy levels of cholesterol and to resolve in case you ought to proceed to take it. Blood exams could also be wanted to test for negative effects.
Utilizing this medication when you are pregnant can hurt your unborn child. Use an efficient type of contraception to maintain from getting pregnant throughout remedy and for a minimum of 2 weeks after your final dose. In the event you suppose you’ve turn into pregnant whereas utilizing the medication, inform your physician immediately.
You need to have a unfavorable being pregnant check earlier than you’ll be allowed to take this medication. In the event you miss a interval when you are utilizing this medication, inform your physician immediately.
Don’t use this medication in case you additionally use any of the next: aprepitant (Emend®), boceprevir (Victrelis®), conivaptan (Vaprisol®), crizotinib (Xalkori®), diltiazem (Cardizem®), imatinib (Gleevec®), mibefradil (Posicor®), nefazodone (Serzone®), telaprevir (Incivek®), verapamil (Calan®), medication to deal with infections (reminiscent of ciprofloxacin, clarithromycin, erythromycin, fluconazole, itraconazole, ketoconazole, posaconazole, telithromycin, voriconazole, Nizoral®), or medication to deal with HIV/AIDS (reminiscent of amprenavir, atazanavir, darunavir/ritonavir, fosamprenavir, indinavir, lopinavir/ritonavir, nelfinavir, ritonavir, saquinavir, tipranavir/ritonavir, Crixivan®, Kaletra®, Norvir®, Reyataz®). Utilizing these medicines collectively may cause critical unwanted effects.
Name your physician immediately when you’ve got extreme diarrhea, lower in how a lot or how typically you urinate, lightheadedness, or tiredness after utilizing this medication.
Utilizing this medication along with lovastatin or simvastatin might improve danger of a critical muscle downside known as myopathy. Test together with your physician immediately when you’ve got unexplained muscle ache, tenderness, or weak spot, particularly in case you even have uncommon tiredness or a fever.
Test together with your physician immediately when you’ve got ache or tenderness within the higher abdomen, pale stools, darkish urine, lack of urge for food, nausea, vomiting, or yellow eyes or pores and skin. These may very well be signs of a critical liver downside (together with fatty liver). Don’t use different medicines to decrease ldl cholesterol that may improve liver fats. Ask your physician about these medicines.
Don’t change your dose or cease taking this medication with out first speaking together with your physician.
Don’t take different medicines until they’ve been mentioned together with your physician. This consists of prescription or nonprescription (over-the-counter [OTC]) medicines and natural or vitamin dietary supplements.
What Are Causes I Shouldn’t Take Juxtapid?
Juxtapid just isn’t applicable for everybody.
You shouldn’t take this treatment in case you:
- Are allergic to Juxtapid or any of its substances
- Have reasonable to extreme liver impairment, energetic liver illness, or unexplained elevated liver operate exams
- Have galactose intolerance hereditary dysfunction
- Are pregnant
Juxtapid could also be prescribed with warning in some folks, provided that the healthcare supplier determines it’s protected. This consists of people who find themselves on dialysis, individuals who abuse alcohol, and females of reproductive potential.
What Different Drugs Might Work together With Juxtapid?
Inform your healthcare supplier about all the medicines you are taking, together with prescription and over-the-counter medicines, and nutritional vitamins or dietary supplements.
If taken with Juxtapid, medicine which can be referred to as reasonable or sturdy CYP3A4 inhibitors may cause very excessive ranges of Juxtapid within the physique. This could improve the danger for unwanted effects and toxicity. For that reason, these medicines shouldn’t be taken with Juxtapid.
Reasonable or sturdy CYP3A4 inhibitors embody:
- Biaxin (clarithromycin)
- Calan, Verelan (verapamil)
- Cipro (ciprofloxacin)
- Diflucan (fluconazole)
- Emend (aprepitant)
- Ery-tab (erythromycin)
- Invirase (saquinavir)
- Kaletra (lopinavir/ritonavir)
- Nizoral (ketoconazole)
- Norvir (ritonavir)
- Noxafil (posaconazole)
- Sporanox (itraconazole)
- Vfend (voriconazole)
- Viracept (nelfinavir)
Grapefruit or grapefruit juice and any merchandise that include grapefruit must be averted when taking Juxtapid as a result of they’ll additionally trigger very excessive Juxtapid ranges within the physique.
In case you are additionally taking a drug referred to as a weak CYP3A4 inhibitor, your dose of Juxtapid must be decreased by half. Examples of weak CYP3A4 inhibitors embody:
Weak CYP3A4 inhibitors additionally embody sure dietary supplements reminiscent of ginkgo and goldenseal. Individuals who take Coumadin (warfarin) will want common monitoring of INR levels and may have a warfarin dosage adjustment. Sure ldl cholesterol medicines, reminiscent of Zocor (simvastatin) or Mevacor (lovastatin), would require a decrease dose when mixed with Juxtapid.
Medicine referred to as P-glycoprotein substrates might require a decrease dosage when taken along with Juxtapid. Some examples embody:
- Colcrys (colchicine)
- Gleevec (imatinib)
- Januvia (sitagliptin)
- Lanoxin (digoxin)
- Onglyza (saxagliptin)
- Pradaxa (dabigatran)
- Ranexa (ranolazine)
- Tekturna (aliskiren)
Individuals who take ldl cholesterol medicine referred to as bile acid sequestrants, reminiscent of colesevelam or cholestyramine, ought to separate the drug from Juxtapid by a minimum of 4 hours.
Different drug interactions might happen with Juxtapid. Seek the advice of your healthcare supplier for an entire record of drug interactions.
What Drugs Are Comparable?
At present, Juxtapid is the one MTP inhibitor prescribed for HoFH, though others could also be in growth. Individuals with HoFH usually take different medicines for his or her situation, along with Juxtapid. Examples of different medicines generally prescribed for HoFH embody:
- Excessive-dose statins, reminiscent of Crestor (rosuvastatin), Lipitor (atorvastatin), or Zocor (simvastatin)
- Zetia (ezetimibe)
- PCSK9 inhibitors (injections), reminiscent of Praluent (alirocumab) or Repatha (evolocumab)
Individuals with HoFH might endure a process repeatedly, known as LDL apheresis. On this process, LDL is eliminated by the blood. In sure circumstances, a liver transplant could also be wanted, as a final resort.
This record is a listing of medication/procedures additionally utilized in HoFH. It’s NOT a listing of medication really useful to take with Juxtapid. Ask your pharmacist or a healthcare practitioner when you’ve got questions.
How Can I Keep Wholesome Whereas Taking Juxtapid?
Earlier than taking Juxtapid, talk about your medical historical past and all medicines you are taking together with your healthcare supplier. Many medicine and dietary supplements work together with Juxtapid. Seek the advice of your healthcare supplier earlier than taking any new treatment.
In case you are recognized with HoFH, there’s assist obtainable. For instance, a registered dietician can advise you on dietary changes, train, and dietary supplements. Along with a nutritious diet, word that grapefruit merchandise can work together with Juxtapid, so keep away from grapefruit when taking this treatment.
Juxtapid may cause liver issues. Your healthcare supplier will order blood work earlier than you begin taking Juxtapid, and repeatedly throughout remedy. Don’t drink multiple alcoholic beverage per day whereas taking Juxtapid, as a result of alcohol can improve the danger of liver harm. In the event you take different medicines that improve the danger of liver issues, reminiscent of Tylenol (acetaminophen), your healthcare supplier might order blood work extra typically.
When taking Juxtapid, comply with your healthcare supplier’s directions to be used. Learn the affected person info leaflet that comes together with your prescription and ask your healthcare supplier when you’ve got any questions.
Medical Disclaimer
Verywell Well being’s drug info is supposed for schooling functions solely and never supposed as a alternative for medical recommendation, analysis, or remedy from a healthcare skilled. Seek the advice of your physician earlier than taking any new treatment(s). IBM Watson Micromedex gives a number of the drug content material, as indicated on the web page.
