Zokinvy Dosage

Generic name: LONAFARNIB 50mg
Dosage form: capsule
Drug class: Miscellaneous metabolic agents

Medically reviewed by Drugs.com. Last updated on Apr 4, 2024.

Recommended Dosage

The starting dosage of ZOKINVY for patients with a BSA of 0.39 m2 and above is 115 mg/m2 twice daily with morning and evening meals (see Table 1) to reduce the risk of gastrointestinal adverse reactions [see Adverse Reactions (6.1)]. An appropriate dosage strength of ZOKINVY is not available for patients with a BSA of less than 0.39 m2 [see Indications and Usage (1)].
After 4 months of treatment, increase the dosage to 150 mg/m2 twice daily with morning and evening meals (see Table 2).
Round all total daily dosages to the nearest 25 mg increment (see Table 1 and Table 2).
If a dose is missed, take the dose as soon as possible with food, up to 8 hours prior to the next scheduled dose. If less than 8 hours remain before the next scheduled dose, skip the missed dose, and resume taking ZOKINVY at the next scheduled dose.

Table 1 provides the BSA-based dosage recommendations for the starting dosage of 115 mg/m2 twice daily.

Table 1: Recommended Dosage and Administration for 115 mg/m2 Body Surface Area-Based Dosing
BSA(m2)	Total Daily Dosage Rounded to Nearest 25 mg	Morning Dosing Number of Capsule(s)		Evening Dosing Number of Capsule(s)
BSA(m2)	Total Daily Dosage Rounded to Nearest 25 mg	ZOKINVY 50 mg	ZOKINVY 75 mg	ZOKINVY 50 mg	ZOKINVY 75 mg
0.39 - 0.48	100	1		1
0.49 - 0.59	125		1	1
0.6 - 0.7	150		1		1
0.71 - 0.81	175	2			1
0.82 - 0.92	200	2		2
0.93 – 1	225	1	1	2

Table 2 provides the BSA-based dosage recommendations for the dosage of 150 mg/m2 twice daily.

Table 2: Recommended Dosage and Administration for 150 mg/m2 Body Surface Area-Based Dosing
BSA(m2)	Total Daily Dosage Rounded to Nearest 25 mg	Morning Dosing Number of Capsule(s)		Evening Dosing Number of Capsule(s)
BSA(m2)	Total Daily Dosage Rounded to Nearest 25 mg	ZOKINVY 50 mg	ZOKINVY 75 mg	ZOKINVY 50 mg	ZOKINVY 75 mg
0.39 - 0.45	125		1	1
0.46 - 0.54	150		1		1
0.55 - 0.62	175	2			1
0.63 - 0.7	200	2		2
0.71 - 0.79	225	1	1	2
0.8 - 0.87	250	1	1	1	1
0.88 - 0.95	275		2	1	1
0.96 – 1	300		2		2

Dosage Modifications Due to Adverse Reactions and Drug Interactions

Table 3: Recommended ZOKINVY Dosage Modifications

Adverse Reaction	Severity	Monitoring and Dose Modifications for ZOKINVY
QTc Interval Prolongation[see Warnings and Precautions (5.1), Drug Interactions (7.1)]	If the QTc interval is greater than or equal to 500 msec	Withhold ZOKINVY until QTc interval is less than 470 msec, then resume ZOKINVY at same dosage. Monitor electrocardiograms (ECGs) prior to initiating ZOKINVY, during treatment, and as clinically indicated.
Gastrointestinal Adverse Reactions [see Adverse Reactions (6.1)]	For patients who have increased their dose of ZOKINVY to 150 mg/m2 twice daily and are experiencing repeated episodes of vomiting and/or diarrhea resulting in dehydration or weight loss	The dose of ZOKINVY can be reduced to the starting dose of 115 mg/m2 twice daily (see Table 1). Ensure ZOKINVY is taken with the morning and evening meals and with an adequate amount of water.
CYP3A Drug Interactions [see Warnings and Precautions (5.2), Adverse Reactions (6.1), Drug Interactions (7.1)]	When moderate CYP3A inhibitors are added for a patient already on steady state ZOKINVY	No dosage adjustment for ZOKINVY is recommended.
	When initiating ZOKINVY in a patient who is concurrently on a moderate CYP3A inhibitor	The patient may be at increased risk of adverse reactions. Monitor the patient closely for adverse reactions for at least the first 7 days after initiating ZOKINVY. If the patient experiences an adverse reaction during the first 7 days of the starting dose or thereafter, consider an alternative therapy that is not a moderate CYP3A inhibitor.

Temporary Discontinuation for Midazolam Use

Temporarily discontinue ZOKINVY for 10 to 14 days before and 2 days after administration of midazolam [see Contraindications (4), Drug Interactions (7.2)].

Preparation and Administration Instructions

Administer ZOKINVY orally with the morning and evening meals.

Patients Able to Swallow Capsules

Administer ZOKINVY capsules whole with a sufficient amount of water. Do not chew the capsules.

Patients Unable to Swallow Capsules

The entire contents of ZOKINVY capsules can be mixed with Ora Blend SF® or Ora-Plus® or, for patients unable to access or tolerate Ora Blend SF or Ora-Plus, the contents of ZOKINVY capsules can be mixed with orange juice or applesauce (see preparation instructions below).
Do not mix with juice containing grapefruit or Seville oranges [see Contraindications (4), Drug Interactions (7.1)].
The mixture must be prepared fresh for each dose and be taken within approximately 10 minutes of mixing.

Preparation of Dose in Ora Blend SF, Ora-Plus, or Orange Juice

For each capsule, empty contents of the capsule into a container containing 5 mL to 10 mL of the liquid.
Mix thoroughly with a spoon.
Consume entire serving.

Preparation of Dose in Applesauce

For each capsule, empty contents of the capsule into a container containing 1 teaspoonful to 2 teaspoonfuls of applesauce.
Mix thoroughly with a spoon.
Consume entire serving.