Formulary
Avacopan: Indications, Dosing, Side Effects and Interactions
Avacopan is a complement 5a receptor (C5aR1) antagonist that inhibits C5a-mediated neutrophil activation, thereby reducing the pro-inflammatory effects of the...
MedNext Academy | 3 min read
Avacopan: Indications, Dosing, Side Effects and Interactions
Avacopan is a complement 5a receptor (C5aR1) antagonist that inhibits C5a-mediated neutrophil activation, thereby reducing the pro-inflammatory effects of the...
Drug action
Avacopan is a complement 5a receptor (C5aR1) antagonist that inhibits C5a-mediated neutrophil activation, thereby reducing the pro-inflammatory effects of the C5a protein on blood vessels.
Indications and dose
**Granulomatosis with polyangiitis (under expert supervision),Microscopic polyangiitis (under expert supervision)**
- **Adult** (By Mouth): 30 mg twice daily, dose to be taken with food, for dose interruption or treatment discontinuation due to side-effects-consult product literature.
Cautions
Immunisation; serious infections Cautions, further information Immunisation Administer vaccinations preferably before starting treatment or during quiescent phase of the disease-safety of immunisation with live viral vaccines unknown. M Infection Use with caution in patients with a history of hepatitis B or C, HIV infection, or tuberculosis-no information available. M Pneumocystis jirovecii pneumonia prophylaxis is recommended-consult local protocol. M
Contraindications
Absolute neutrophil count less than 1.5 x 10 9 /litre (do not initiate); lymphocyte count less than 0.5 x 10 9 /litre (do not initiate); signs of liver disease-consult product literature; white blood cell count less than 3.5 x 10 9 /litre (do not initiate)
Side effects
Common or very common Abdominal pain upper; diarrhoea; headache; hepatic disorders; increased risk of infection; leucopenia; nausea; neutropenia; vomiting Uncommon Angioedema Frequency not known Cardiac disorder; vanishing bile duct syndrome
Interactions
**Other interactions (16):**
- Avacopan is a substrate of CYP3A4.
- Co-administration of inducers or inhibitors of this enzyme may affect the pharmacokinetics of avacopan.
- Effect of strong CYP3A4 inducers on avacopan Co-administration of avacopan with rifampicin, a strong CYP3A4 enzyme inducer, resulted in a decrease in area-under-the-concentration time curve (AUC)...
- Since this interaction may result in loss of efficacy of avacopan, the use of strong CYP3A4 enzyme inducers (e.g., carbamazepine, enzalutamide, mitotane, phenobarbital, phenytoin, rifampicin, and St.
- John's Wort) with avacopan is to be avoided (see section 4.4).
- Patients anticipated to require long-term administration of these medicinal products are not to be treated with avacopan.
Pregnancy
Avoid-toxicity in animal studies. M
Breast feeding
Avoid-limited information available. M
Hepatic impairment
Avoid in severe impairment (no information available). M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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