Select a medication above to begin.
Camzyos
mavacamten
Black Box Warnings .
Appropriate Use
avail. only through restricted distribution program (Camzyos REMS) due to heart failure risk from systolic dysfxn; prescribers, pts, and pharmacies must enroll at 1-833-628-7367 or www.CAMZYOSREMS.com
Heart Failure Risk
LVEF decr. may cause heart failure from systolic dysfxn; echocardiogram required before tx initiation and during tx; avoid tx initiation in pts w/ LVEF <55%; interrupt tx if LVEF <50%, heart failure s/sx, or worsening clinical status; contraindicated w/ strong CYP2C19 inhibitors, moderate-strong CYP2C19 inducers, or moderate-strong CYP3A4 inducers
Adult Dosing .
Dosage forms: CAP: 2.5 mg, 5 mg, 10 mg, 15 mg
Restricted Distribution in US
- [1-833-628-7367 or www.CAMZYOSREMS.com for more info]
obstructive hypertrophic cardiomyopathy, NYHA Class II-III
- [2.5-15 mg PO qd]
- Start: 5 mg PO qd, titrate dose based on Valsalva LVOT gradient and LVEF q4wk x12wk, then q12wk; Max: 15 mg/day; Info: consider delay dose incr. or hold tx if serious illness or arrhythmia; hold tx if LVEF <50% and restart when LVEF 50% or greater; D/C tx if LVEF <50% x2 on 2.5 mg PO qd; see pkg insert for tx initiation, maintenance, and interruption dose adjustment details; do not open cap
renal dosing
- [see below]
- eGFR >30: no adjustment; eGFR <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pregnancy
- LVEF <55% (tx initiation use)
- caution: CYP2C19 poor metabolizers
- caution: pts of childbearing potential
- caution: LVEF <50%
- caution: arrhythmia
- caution: illness, serious
Drug Interactions .
Overview
mavacamten
cardiac myosin inhibitor
- CYP2C19 substrate
- CYP3A4 substrate
- CYP2C9 inducer, moderate
- CYP2C19 inducer, moderate
- CYP3A4 inducer, moderate
- cardiotoxic effects
Contraindicated
- apalutamide
- bosentan
- butalbital
- carbamazepine
- cenobamate
- dabrafenib
- dicloxacillin
- efavirenz
- encorafenib
- enzalutamide
- etravirine
- fexinidazole
- fluconazole
- fluoxetine
- fluvoxamine
- fosphenytoin
- ivosidenib
- lonafarnib
- lopinavir/ritonavir
- lorlatinib
- lumacaftor/ivacaftor
- mitapivat
- mitotane
- modafinil
- nafcillin
- pacritinib
- pentobarbital
- pexidartinib
- phenobarbital
- phenytoin
- primidone
- ranolazine
- repotrectinib
- rifabutin
- rifampin
- rifapentine
- sotorasib
- St. John's wort
Avoid/Use Alternative
- abemaciclib
- alfentanil
- alpelisib
- aprepitant
- armodafinil
- artemether/lumefantrine
- atazanavir
- atogepant
- atrasentan
- avacopan
- avapritinib
- axitinib
- bedaquiline
- belzutifan
- bexarotene
- bictegravir
- bosutinib
- brigatinib
- buprenorphine
- buspirone
- cabozantinib
- capivasertib
- capmatinib
- cariprazine
- ceritinib
- clarithromycin
- clobazam
- cobicistat
- cobimetinib
- codeine
- crizotinib
- danshen
- daridorexant
- darolutamide
- defactinib
- deflazacort
- desogestrel (contraceptive)
- deuruxolitinib
- dexamethasone
- diazoxide
- dienogest (contraceptive)
- dihydrocodeine
- diltiazem
- disopyramide
- dolutegravir
- doravirine
- doxorubicin
- dronedarone
- drospirenone (contraceptive)
- duvelisib
- echinacea
- elacestrant
- elafibranor
- elagolix
- elbasvir
- elexacaftor/tezacaftor/ivacaftor
- elvitegravir
- enasidenib
- ensartinib
- entrectinib
- epirubicin
- erdafitinib
- erlotinib
- eslicarbazepine acetate
- estradiol (contraceptive)
- ethinyl estradiol (contraceptive)
- ethynodiol (contraceptive)
- etonogestrel (contraceptive)
- everolimus
- fedratinib
- felbamate
- felodipine
- fentanyl
- finerenone
- fosamprenavir
- fosaprepitant
- fostamatinib
- fruquintinib
- ganaxolone
- garlic
- gilteritinib
- ginkgo
- ginseng, Asian
- glasdegib
- glecaprevir
- glycerol phenylbutyrate
- grapefruit
- grazoprevir
- griseofulvin
- hydrocodone
- ibrexafungerp
- ibrutinib
- idarubicin
- idelalisib
- imatinib
- infigratinib
- irinotecan
- isavuconazonium
- isradipine
- istradefylline
- itraconazole
- ivacaftor
- ketoconazole
- larotrectinib
- lazertinib
- lefamulin
- lemborexant
- lenacapavir
- leniolisib
- letermovir
- levoketoconazole
- levonorgestrel (contraceptive)
- levonorgestrel (post-coital contraceptive)
- lumateperone
- macitentan
- maraviroc
- medroxyprogesterone (contraceptive)
- meperidine
- methadone
- midazolam
- midostaurin
- mifepristone
- mobocertinib
- naldemedine
- naloxegol
- nefazodone
- nelfinavir
- neratinib
- netupitant
- nevirapine
- nicardipine
- nifedipine
- nilotinib
- nirmatrelvir
- nirogacestat
- nisoldipine
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norgestimate (contraceptive)
- norgestrel (contraceptive)
- odevixibat
- olaparib
- oliceridine
- olutasidenib
- omaveloxolone
- oxcarbazepine
- oxycodone
- palbociclib
- palovarotene
- pemigatinib
- perampanel
- pimavanserin
- pioglitazone
- pirtobrutinib
- ponatinib
- pralsetinib
- praziquantel
- prednisone
- pretomanid
- quizartinib
- revumenib
- ribociclib
- rilpivirine
- rimegepant
- ripretinib
- ritonavir
- rivaroxaban
- roflumilast
- rolapitant
- rufinamide
- samidorphan
- sarilumab
- segesterone (contraceptive)
- selpercatinib
- selumetinib
- simvastatin
- siponimod
- somatropin
- sonidegib
- sparsentan
- stiripentol
- sufentanil
- suzetrigine
- tadalafil
- tamoxifen
- tasimelteon
- tazemetostat
- tecovirimat
- telotristat ethyl
- tezacaftor/ivacaftor
- thiotepa
- ticagrelor
- tipranavir
- tocilizumab
- tofacitinib
- tolvaptan
- topiramate
- toremifene
- tovorafenib
- tramadol
- ulipristal (post-coital contraceptive)
- valbenazine
- vamorolone
- vanzacaftor/tezacaftor/deutivacaftor
- velpatasvir
- vemurafenib
- venetoclax
- verapamil
- vinblastine
- voclosporin
- vonoprazan
- vorasidenib
- voriconazole
- voxelotor
- voxilaprevir
- zanubrutinib
- zuranolone
Monitor/Modify Tx
- abiraterone acetate
- acalabrutinib
- acebutolol
- adagrasib
- adalimumab
- ado-trastuzumab emtansine
- aldesleukin
- alogliptin
- alprazolam
- aminophylline
- amiodarone
- amitriptyline
- amlodipine
- anagrelide
- asciminib
- atenolol
- atorvastatin
- avatrombopag
- avelumab
- belumosudil
- berberine
- berotralstat
- betamethasone
- betaxolol
- bevacizumab
- bezlotoxumab
- bicalutamide
- binimetinib
- bisoprolol
- bortezomib
- brexpiprazole
- butorphanol
- calcitriol
- cannabidiol
- cannabis
- capecitabine
- carfilzomib
- carvedilol
- celecoxib
- certolizumab pegol
- chloramphenicol
- chlorzoxazone
- cholecalciferol (vitamin D3)
- cilostazol
- cimetidine
- ciprofloxacin
- clevidipine
- clofazimine
- clopidogrel
- clotrimazole oropharyngeal
- clozapine
- conivaptan
- cranberry
- crinecerfont
- cyclophosphamide
- cyclosporine
- danazol
- darunavir
- daunorubicin
- diclofenac
- diosmin
- dofetilide
- doxercalciferol
- erythromycin
- esmolol
- esomeprazole
- etanercept
- ethosuximide
- fam-trastuzumab deruxtecan
- flecainide
- flibanserin
- fludrocortisone
- fluorouracil
- gepotidacin
- givinostat
- givosiran
- glimepiride
- goldenseal
- golimumab
- guanfacine
- haloperidol
- hydrocortisone
- hydroxychloroquine
- ibutilide
- ifosfamide
- imipramine
- infliximab
- interferon beta 1a
- interferon beta 1b
- interferon gamma 1b
- isoniazid
- kratom
- labetalol
- lapatinib
- lenvatinib
- lidocaine
- linagliptin
- lomitapide
- lovastatin
- luliconazole topical
- lurasidone
- macimorelin
- margetuximab
- maribavir
- mavorixafor
- meropenem
- metoprolol
- mexiletine
- mirdametinib
- mirtazapine
- mitoxantrone
- nadolol
- nateglinide
- nebivolol
- nimodipine
- nortriptyline
- omeprazole
- osilodrostat
- osimertinib
- pazopanib
- peginterferon beta 1a
- peppermint
- pertuzumab
- pibrentasvir
- pindolol
- posaconazole
- procainamide
- propafenone
- propranolol
- quercetin
- quetiapine
- quinidine (antiarrhythmic)
- remdesivir
- repaglinide
- resveratrol
- ritlecitinib
- ropeginterferon alfa-2b
- rosiglitazone
- rucaparib
- saxagliptin
- sildenafil
- sirolimus
- sitagliptin
- sorafenib
- sotalol
- spironolactone
- sunitinib
- tacrolimus
- temsirolimus
- theophylline
- tiagabine
- timolol
- tivozanib
- torsemide
- trabectedin
- trametinib
- trastuzumab
- treosulfan
- triclabendazole
- trofinetide
- tucatinib
- ubrogepant
- vaborbactam
- vandetanib
- vilazodone
- viloxazine
- vortioxetine
- warfarin
- xanomeline
- zanidatamab
- zenocutuzumab
- zileuton
- zonisamide
Caution Advised
- abrocitinib
- albendazole
- aliskiren
- apixaban
- apremilast
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- avanafil
- brivaracetam
- budesonide
- carisoprodol
- clindamycin
- colchicine
- copanlisib
- cortisone
- dapsone
- dasatinib
- dexlansoprazole
- diazepam
- dronabinol
- drospirenone (hormone replacement)
- eliglustat
- enfortumab vedotin
- eszopiclone
- ethinyl estradiol (hormone replacement)
- etoposide
- etrasimod
- exemestane
- fenfluramine
- fesoterodine
- finasteride
- fluvastatin
- fostemsavir
- futibatinib
- gefitinib
- gepirone
- glyburide
- isotretinoin
- ivabradine
- ixabepilone
- ixazomib
- lansoprazole
- levonorgestrel (hormone replacement)
- levonorgestrel intrauterine device (contraceptive)
- mefloquine
- methylprednisolone
- metoclopramide
- nintedanib
- norethindrone acetate (hormone replacement)
- norgestimate (hormone replacement)
- ondansetron
- paclitaxel
- panobinostat
- pitolisant
- polatuzumab vedotin
- prednisolone
- progesterone (hormone replacement)
- progesterone vaginal (hormone replacement)
- quinidine (CYP2D6 inhibitor)
- quinine
- ramelteon
- regorafenib
- relugolix
- risperidone
- ruxolitinib
- sirolimus albumin-bound
- suvorexant
- terbinafine
- trazodone
- tretinoin
- triamcinolone
- triazolam
- upadacitinib
- vincristine
- vinorelbine
- vorapaxar
- zaleplon
- zolpidem
Safety/Monitoring .
Monitoring Parameters
pregnancy test at baseline; echocardiogram at baseline, then q4wk x12wk, then q12wk and as clinically indicated
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use during pregnancy; no human data available; risk of fetal harm, incl. decr. fetal birth weight, decr. bone density, skeletal malformations, and post-implantation loss based on animal data at 1x MRHD
Pregnancy Reporting
report pregnancy during tx or w/in 4mo after D/C to Bristol-Myers Squibb Co. at 1-800-721-5072 or www.bms.com
Individuals of Reproductive Potential
obtain negative pregnancy test before tx start; avoid pregnancy by using effective contraception (e.g. combined hormonal contraceptive containing ethinyl estradiol and norethindrone, other combined hormonal contraceptive plus non-hormonal method, or contraceptive method not affected by CYP450 induction), during tx and x4mo after D/C in pts of childbearing potential
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: liver; CYP450: 2C9, 2C19 (primary), 3A4 substrate
Excretion: urine 85% (3% unchanged), feces 7% (1% unchanged); Half-life: 6-9 days, 23 days (CYP2C19 poor metabolizers)
Subclass: Hypertrophic Cardiomyopathy: Cardiac Myosin Inhibitors
Mechanism of Action
reversibly inhibits cardiac myosin, decreasing dynamic LVOT obstruction and improving cardiac filling pressures
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.