Juxtapid (lomitapide) is used to treat a rare, genetic type of high cholesterol, known as homozygous familial hypercholesterolemia (HoFH). It's typically used along with other cholesterol-lowering medications and dietary changes, such as a low-fat diet. Because it has a risk of severe liver damage, only certified healthcare providers can prescribe this medication.
Juxtapid (lomitapide) is a microsomal triglyceride transfer protein (MTP) inhibitor. MTP is a protein in your body that helps make cholesterol. Juxtapid (lomitapide) works by blocking MTP, which stops your body from making cholesterol, including low-density lipoprotein cholesterol (LDL-C, a type of "bad cholesterol"). This helps lower the levels of "bad cholesterol" in your blood.
| Common Brands | Juxtapid |
|---|---|
| Drug Class | MTP inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Contact your healthcare provider immediately if you experience any of the following.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Arm, back, or jaw pain
chest pain or discomfort
chest tightness or heaviness
dark urine
fast, irregular, pounding, or racing heartbeat or pulse
light-colored stools
loss of appetite
sweating
trouble breathing
unusual tiredness or weakness
upper right abdominal or stomach pain
yellow eyes and skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
back pain
belching
chills
decreased weight
dizziness
excess air or gas in the stomach or intestines
frequent urge to defecate
full or bloated feeling
general feeling of discomfort or illness
headache
indigestion
joint pain
muscle aches and pains
passing gas
pressure in the stomach
shivering
stomach discomfort, upset, or pain
straining while passing stool
stuffy or runny nose
sweating
swelling of the abdominal or stomach area
trouble sleeping
weakness
Incidence not known
Hair loss or thinning of the hair
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Juxtapid (lomitapide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
There's a risk of serious liver damage and buildup of fat in your liver (hepatic steatosis) while taking Juxtapid (lomitapide). This medication should not be used if you currently have liver disease or damage. If you have a history of liver disease, let your healthcare provider know before you start Juxtapid (lomitapide), since they'll need to check if the medication is safe for you.
To make sure your liver is healthy, you'll need to get blood tests done before you start Juxtapid (lomitapide) and routinely while you're taking the medication. Depending on your labs, your provider might adjust your dose. If you have symptoms of liver damage, such as yellowing of your skin or eyes (jaundice), stomach pain or swelling, loss of appetite, dark urine, nausea, vomiting, tiredness, weakness, or confusion, stop taking Juxtapid (lomitapide) and let your provider know right away.
Because of this risk of serious liver damage, the FDA has required a Risk Evaluation and Mitigation Strategy (REMS) Program for Juxtapid (lomitapide). Under this program, Juxtapid (lomitapide) is only available at select pharmacies with a prescription from a certified provider. The REMS program educates you and your healthcare provider about this risk and the need for routine liver monitoring to make sure the medication is safe for you. For questions about the Juxtapid (lomitapide) REMS program, visit the website or call 1-855-JUXTAPID (1-855-898-2743).
Juxtapid (lomitapide) should never be used during pregnancy because of the risk of serious harm to your unborn baby. Studies show serious harm and death to unborn babies in pregnant animals. Because of this risk, you'll need to get a pregnancy test done before starting Juxtapid (lomitapide) to make sure you're not pregnant. Use birth control while taking Juxtapid (lomitapide) and for 2 weeks after your last dose of the medication to avoid becoming pregnant. If you plan on becoming pregnant or you think you might be pregnant, stop using Juxtapid (lomitapide) and call your healthcare provider right away.
Juxtapid (lomitapide) can lower the absorption of vitamins that dissolve in fat (fat-soluble vitamins), such as vitamin E. The same is true for dietary supplements containing fatty acids, such as alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). These fatty acids are important for your body's growth and development. Omega-3 fatty acids is a common supplement that contains some of these fatty acids. To prevent these levels from getting too low, your provider will suggest you take daily vitamin E and fatty acid supplements along with Juxtapid (lomitapide). Ask your pharmacist or provider about which supplements and dosages to take.
Stomach-related side effects can occur quite commonly while taking Juxtapid (lomitapide), especially if you're eating foods high in fat. It's important to follow a low-fat diet while taking this medication to prevent stomach-related symptoms, such as diarrhea, nausea, vomiting, indigestion, pain, and gas. Some severe cases of diarrhea might require treatment at a hospital. If you have severe diarrhea along with dizziness, lightheadedness, tiredness, or you're urinating less often, stop taking Juxtapid (lomitapide) and let your healthcare provider know right away.
Juxtapid (lomitapide) can interact with many medications. Certain medications can raise Juxtapid (lomitapide) levels in your body and raise your risk of side effects, such as liver damage and stomach symptoms. These medications include verapamil, amlodipine (Norvasc), fluconazole (Diflucan), and fluoxetine (Prozac), among many others. Avoid grapefruit while taking Juxtapid (lomitapide) because this can also raise medication levels in your body and raise the risk of side effects. Let your healthcare provider know about all the medications and supplements you're taking or plan to take so they can make sure Juxtapid (lomitapide) is safe for you to take. You might need to stop or change certain medications, or your provider might lower your Juxtapid (lomitapide) dose.
Juxtapid (lomitapide) can lead to absorption problems and diarrhea if you have certain rare, genetic health conditions that cause absorption problems. These include galactose intolerance, the Lapp lactase deficiency, and glucose-galactose absorption problems. Avoid using Juxtapid (lomitapide) if you have any of these conditions. Discuss other options with your healthcare provider.
Your dose will be adjusted based on how well you tolerate the medication and how well it's working to control your cholesterol.
The typical starting dose is 5 mg by mouth once daily. The maximum dose is 60 mg by mouth once daily.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Juxtapid (lomitapide) will not be safe for you to take.
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When you're taking Juxtapid, your body doesn't absorb fat as well. Eating foods high in fat can cause unpleasant side effects, such as stomach pain, bloating, nausea, and diarrhea. A low-fat diet helps lower the risk of side effects and stomach problems. If you need help starting or maintaining a low-fat diet, discuss with your healthcare provider or reach out to a Compass Clinical Patient Educator for help.
Juxtapid has a risk of serious liver damage, and drinking alcohol can raise your chances of having liver problems. If you have a history of liver disease or if you frequently drink alcohol, limit your alcohol intake to one alcoholic drink per day. If you're having trouble limiting your alcohol use, discuss other options with your healthcare provider.
Juxtapid needs special monitoring because of its risk of serious liver problems, so it's only available at certified pharmacies. Unlike other medications, the FDA requires this medication to have a Risk Evaluation and Mitigation Strategy (REMS) Program. This program educates you and your healthcare provider about using this medication and makes sure that the medication is safe and appropriate for you. For more questions about the Juxtapid REMS program, ask your provider, visit the website (link above), or call 1-855-JUXTAPID (1-855-898-2743).
There isn't enough data to show if Juxtapid lowers your chances of developing problems from high cholesterol, such as heart attack, stroke, or death. If you're worried about these conditions, discuss your concerns with your healthcare provider.
No. There aren't any studies looking at the use of Juxtapid in pregnant people, but based on studies done in pregnant animals, it can cause serious harm to uborn babies. If you plan on becoming pregnant or if you believe you might be pregnant, stop using Juxtapid and let your healthcare provider know right away. If you become pregnant while taking Juxtapid, call 1-877-902-4099 or visit the website to sign up for the Global Lomitapide Pregnancy Exposure Registry. This registry monitors side effects and outcomes of Juxtapid in pregnant people and babies.
