Camzyos Disease Interactions

Mavacamten reduces systolic contraction/left ventricular ejection fraction (LVEF) and can cause heart failure (due to systolic dysfunction) or totally block ventricular function. Patients with a serious intercurrent illness (e.g., serious infection) or arrhythmia (e.g., atrial fibrillation or other uncontrolled tachyarrhythmia) are at greater risk of developing systolic dysfunction and heart failure. Echocardiogram assessments of LVEF and assessments of the patient's clinical status are required before and regularly during therapy; the mavacamten dose should be adjusted accordingly. New/worsening arrhythmia, dyspnea, chest pain, fatigue, palpitations, leg edema, or elevations in N-terminal pro-B-type natriuretic peptide (NT-proBNP) may be signs/symptoms of heart failure; cardiac function should be evaluated. Asymptomatic LVEF reduction, intercurrent illnesses, and arrhythmias require additional dosing considerations. Initiation of mavacamten in patients with LVEF less than 55% is not recommended; mavacamten should be interrupted if LVEF is less than 50% at any visit or if the patient has heart failure symptoms or worsening clinical status.

Mavacamten should be used with caution in patients with severe liver dysfunction (Child-Pugh C); the effect of severe liver dysfunction is unknown. Mavacamten exposure (AUC) increased up to 220% in patients with mild to moderate liver dysfunction (Child-Pugh A or B) compared to patients with normal liver function; however, no additional dose adjustment is needed with the recommended dose titration algorithm and monitoring plan.

Mavacamten should be used with caution in patients with severe renal dysfunction (estimated glomerular filtration rate [eGFR] 15 to 30 mL/min/1.73 m2) and kidney failure (eGFR less than 15 mL/min/1.73 m2, including those on dialysis); the effects of severe renal dysfunction and kidney failure (including patients on dialysis) are unknown. No clinically significant differences in mavacamten pharmacokinetics were observed based on mild to moderate renal dysfunction (eGFR 30 to 89 mL/min/1.73 m2).