Formulary
Mavacamten: Indications, Dosing, Side Effects and Interactions
Mavacamten is a cardiac myosin inhibitor that acts to normalise cardiac contractility, reduce dynamic left ventricular outflow tract obstruction, and improve...
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Mavacamten: Indications, Dosing, Side Effects and Interactions
Mavacamten is a cardiac myosin inhibitor that acts to normalise cardiac contractility, reduce dynamic left ventricular outflow tract obstruction, and improve...
Drug action
Mavacamten is a cardiac myosin inhibitor that acts to normalise cardiac contractility, reduce dynamic left ventricular outflow tract obstruction, and improve cardiac filling pressures.
Indications and dose
**Symptomatic obstructive hypertrophic cardiomyopathy (initiated by a specialist)**
- **Adult** (By Mouth): (consult product literature).
Cautions
Risk factors for systolic dysfunction Cautions, further information Systolic dysfunction Patients with a serious intercurrent illness (e.g. infection or arrhythmia) or undergoing major cardiac surgery may be at greater risk of systolic dysfunction and progress to heart failure. M For treatment interruption due to systolic dysfunction-consult product literature.
Contraindications
Left ventricular ejection fraction less than 55% (do not initiate)
Side effects
Common or very common Dizziness; dyspnoea; syncope; systolic dysfunction
Interactions
**Severe interactions:**
- Coadministration of mavacamten with a strong inducer of both CYP2C19 and CYP3A4 (e.g., rifampicin) is expected to significantly affect the pharmacokinetics (PK) of mavacamten and leads to reduced...
**Other interactions (41):**
- Pharmacodynamic interactions If treatment with a new negative inotrope is initiated or if the dose of a negative inotrope is increased in a patient receiving mavacamten, close medical supervision...
- Pharmacokinetic interactions Effect of other medicinal products on mavacamten In CYP2C19 intermediate, normal, rapid and ultrarapid metabolisers, mavacamten is primarily metabolised by CYP2C19 and...
- CYP2C19 inhibitors/inducers and CYP3A4 inhibitors/inducers may thus affect the clearance of mavacamten and increase/decrease mavacamten plasma concentration, and this will depend on the CYP2C19...
- All clinical drug-drug interaction studies mainly enrolled CYP2C19 normal metabolisers and no CYP2C19 poor metabolisers were included in the assessment of the drugdrug interaction and therefore the...
- Strong CYP2C19 plus strong CYP3A4 inhibitors Coadministration of mavacamten with the combination of a strong CYP2C19 and a strong CYP3A4 inhibitor is contraindicated (see section 4.3).
- CYP2C19 inhibitors The effect of a moderate and strong CYP2C19 inhibitor on the PK of mavacamten was not investigated in a clinical drugdrug interaction study.
Pregnancy
Avoid (toxicity in animal studies). M
Breast feeding
Avoid (no information available). M
Hepatic impairment
Caution in severe impairment (no information available). M Dose adjustments For dose adjustments in mild to moderate impairment-consult product literature.
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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