Lomitapide | Side Effects, Dosage, Uses & More
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Generic Name:

lomitapide, Oral capsule

All Brands

  • Juxtapid
SECTION 1 of 4

Highlights for lomitapide

Oral capsule
1

Lomitapide is used to treat homozygous familial hypercholesterolemia. This rare condition is inherited (passed down through families). With this condition, cholesterol cannot be removed from your body normally. Lomitapide is used along with diet changes and other treatments to lower the amount of cholesterol and other fatty substances in your blood.

2

Lomitapide is available as a brand-name drug called Juxtapid. It’s not available as a generic drug. It comes in the form of a capsule you take by mouth.

3

Lomitapide can cause liver problems. Your doctor will do blood tests to measure liver enzymes before and during your treatment with this medication. 

4

Lomitapide is a category X pregnancy drug. These drugs should never be used during pregnancy. 

5

The more common side effects of this drug include diarrhea, nausea, vomiting, stomach pain, heartburn, or gas.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Liver problems warning: Lomitapide can cause your liver enzymes to increase. Increased liver enzymes are a sign of damage to your liver. Lomitapide can also cause an increased amount of fat in your liver. Hepatic steatosis (fatty liver disease) can cause worsening liver disease, liver failure, and even death if not treated. Your doctor will monitor your liver health closely while you take this drug. If your liver enzymes are raised, your doctor may lower your dose of this medication.

Risk evaluation and mitigation strategies (REMS) warning: Lomitapide is only available through a restricted program. This is because of its risk of liver problems. You can only get this medication prescribed by a doctor and picked up at a pharmacy that is certified under the REMS program.

Pregnancy

Lomitapide can cause serious harm to your pregnancy if you take this medication while pregnant. If you are a female of childbearing age, you should have a negative pregnancy test before taking this medication. You should also use reliable birth control while taking this drug.

Low levels of vitamins and nutrients

Lomitapide may decrease the level of certain fat-soluble vitamins and minerals in your body. These include vitamin E and fatty acids. Your doctor should start you on daily supplements that contain fat-soluble vitamins. If you have chronic bowel or pancreatic diseases, you may be at an increased risk of having low levels of these nutrients.

Stomach problems

Diarrhea, nausea, vomiting, and stomach pain and discomfort are very common in people taking lomitapide. You may lower your risk of these problems if you follow a strict low-fat diet. Talk to your doctor for more information.

What is lomitapide?

omitapide is a prescription drug. It comes in the form of a capsule you take by mouth. Lomitapide may be used as part of a combination therapy. This means you may need to take it with other medications.

Lomitapide is available as a brand-name drug called Juxtapid. It’s not available as a generic drug.

Why it's used

Lomitapide helps to lower the amount of cholesterol and other fatty substances in your blood. It’s used to treat homozygous familial hypercholesterolemia. With this rare, inherited condition, cholesterol cannot be removed from your body normally.

More Details

How it works

Lomitapide belongs to a class of drugs called microsomal triglyceride transfer protein inhibitors (MTP inhibitors). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

More Details

Why it's used

 

Lomitapide helps to lower the amount of cholesterol and other fatty substances in your blood. It’s used to treat homozygous familial hypercholesterolemia. With this rare, inherited condition, cholesterol cannot be removed from your body normally. 
Lowering your blood level of cholesterol and fats may help prevent heart disease, chest pain, stroke, or heart attack. Lomitapide is used along with diet changes and other treatments.

How it works

Lomitapide belongs to a class of drugs called microsomal triglyceride transfer protein inhibitors (MTP inhibitors). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.  

Lomitapide works by causing the body to make cholesterol more slowly. This lowers the amount of cholesterol that may build up on the walls of your arteries. Such buildup could block blood flow to your heart, brain, and other parts of your body. This can lead to a stroke, heart attack, or other serious health problems.

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lomitapide Side Effects

Oral capsule

More Common Side Effects

The more common side effects that can occur with use of lomitapide include:

  • diarrhea

  • nausea

  • vomiting

  • stomach pain

  • heartburn

  • gas

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  •  Liver problems. Symptoms can include:

    • nausea
    • vomiting
    • stomach pain that changes, gets worse, or does not go away
    • fever
    • yellowing of your skin or eyes
    • tiredness
    • flu-like symptoms
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Lomitapide doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

lomitapide May Interact with Other Medications

Oral capsule

Lomitapide can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Food interactions

Avoid grapefruit and grapefruit juice. Grapefruit and its juice can increase levels of lomitapide in your body. This raises your risk of dangerous side effects.

Alcohol interaction

Having drinks that contain alcohol may increase your risk of liver problems, or make liver problems worse. You should not have more than 1 alcoholic drink each day while taking this drug.

Medications that might interact with this drug

Antibiotics

When taken with lomitapide, some of these drugs can increase the amount of lomitapide in your body. This raises your risk of side effects. Lomitapide should not be used with these drugs. Examples of these drugs include:

  • clarithromycin
  • erythromycin
  • telithromycin
  • ciprofloxacin

Antifungal drugs

When taken with lomitapide, some of these drugs can increase the amount of lomitapide in your body. This raises your risk of side effects. Lomitapide should not be used with these drugs. Examples of these drugs include:

  • ketoconazole
  • fluconazole
  • itraconazole
  • posaconazole
  • voriconazole

Antiviral drugs

When taken with lomitapide, certain drugs used to treat viruses can increase the amount of lomitapide in your body. This raises your risk of side effects. You should not use lomitapide with these drugs. Examples of these drugs include:

  • indinavir
  • lopinavir/ritonavir
  • nelfinavir
  • ritonavir
  • saquinavir,telaprevir
  • tipranavir/ritonavir
  • amprenavir
  • atazanavir
  • darunavir/ritonavir
  • fosamprenavir

Anxiety drugs

Alprazolam is used to treat anxiety. When taken with lomitapide, it can increase the amount of lomitapide in your body. This raises your risk of side effects. Your doctor may give you a lower dose of alprazolam.

Blood-thinning drugs

Warfarin is used to thin the blood. Taking warfarin with lomitapide will increase the amount of warfarin in your body. This raises your risk of bleeding. Your doctor should monitor your risk of bleeding. This is especially important when your dose of lomitapide is changed.

Cholesterol drugs

Certain drugs that lower cholesterol are called bile acid sequestrants. When taken with lomitapide, these drugs can lower the amount of lomitapide in your body. This can keep it from working well. To help prevent this problem, take these drugs 4 hours before or after taking lomitapide. Examples of these drugs include:

  • colesevelam
  • cholestyramine
  • colestipol

Other cholesterol drugs can increase your risk of muscle problems when taking lomitapide. These problems include myalgia (muscle pain), and a dangerous condition called rhabdomyolysis, which breaks down muscle. Your doctor may lower your dose of these cholesterol drugs. Examples of these drugs include:

  • simvastatin
  • lovastatin

Heart drugs

When taken with lomitapide, some of these drugs can increase the amount of lomitapide in your body. This raises your risk of side effects. Your doctor may give you a lower dose of these drugs. Examples of these drugs include:

  • digoxin
  • diltiazem
  • verapamil
  • amiodarone
  • amlodipine
  • ranolazine

Other drugs

Taking lomitapide with certain drugs raises your risk of side effects from lomitapide. Your doctor may give you a lower dose of lomitapide. Examples of these drugs include:

  • atorvastatin
  • bicalutamide
  • cilostazol
  • cimetidine
  • cyclosporine
  • fluoxetine
  • fluvoxamine
  • ginkgo
  • goldenseal
  • isoniazid
  • lapatinib
  • nilotinib
  • pazopanib
  • ranitidine
  • ranolazine
  • ticagrelor
  • zileuton

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Lomitapide warnings
liver problems
People with liver problems

Lomitapide can cause serious liver problems. Tell your doctor if you have had liver problems in the past, including liver problems while taking other medications.

Your doctor will have you take a blood test to check your liver enzymes before and during treatment with lomitapide. Your doctor will also adjust your dose based on the results of these tests. Your treatment with lomitapide may be stopped if it is damaging your liver.

chronic bowel or pancreatic diseases
People with chronic bowel or pancreatic diseases

Lomitapide may decrease the level of certain fat-soluble vitamins and minerals in your body. These include vitamin E and fatty acids. If you have a chronic bowel or pancreatic disease, you are more likely to have a malabsorption disorder. This is when your body doesn’t absorb nutrients properly from your food. This type of disorder raises your risk of low vitamin and nutrient absorption while taking lomitapide.

galactose intolerance
People with disorders of galactose intolerance

If you have a rare, inherited problem with tolerating galactose in your diet, you should not take lomitapide. You may be at increased risk of diarrhea and malabsorption (when the body doesn’t properly absorb nutrients from food).

pregnant women
Pregnant women

Lomitapide is a category X pregnancy drug. Category X drugs should never be used during pregnancy.

If you are a female of childbearing age, you should have a pregnancy test that has a negative result before taking this drug. You should also use reliable birth control while taking this drug.

breastfeeding
Women who are breast-feeding

It is not known if lomitapide passes into breast milk. Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

for seniors
For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.

for children
For children

This medication has not been studied in children. It should not be used in people younger than 18 years.

call doctor
When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

allergies
Allergies

Lomitapide can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take lomitapide (Dosage)

Oral capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Homozygous familial hypercholesterolemia

Brand: Juxtapid

Form: Oral capsule
Strengths: 5 mg, 10 mg, 20 mg, 30 mg, 40 mg, 60 mg
Adult dosage (ages 18–64 years)

Lomitapide should be taken once daily. The starting daily dose is 5 mg once per day. The maximum daily dose is 60 mg once per day.

Child dosage (ages 0–17 years)

This medication has not been studied in children. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.

Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Kidney disease: If you have end-stage kidney disease and are on dialysis, your maximum dose of this drug should be 40 mg once per day.

Liver disease: If you have mild liver disease, your maximum dose of this drug should be 40 mg once per day. If you have moderate or severe liver disease or active liver disease, you should not take this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Board

Lomitapide comes with risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your cholesterol level will not be lowered. As a result, your risk of heart disease, heart attack, or stroke will be increased.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug include increased side effects, such as:

  • diarrhea
  • nausea
  • vomiting
  • stomach pain
  • heartburn
  • gas

An overdose can also cause liver damage. If you think you’ve taken too much of the drug, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room. 

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your cholesterol levels should be lower when your doctor performs a blood test.

Lomitapide is used for long-term treatment.

This drug should be taken without food

Taking this drug with food may increase your risk of stomach problems such as nausea, vomiting, or stomach pain.

Take this medication with a glass of water.

This drug should be taken once daily

Take it at least 2 hours after the evening meal.

Store this drug carefully

  • Store lomitapide at or near room temperature. Keep it between 68°F and 86°F (20°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Prescription is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will do blood tests from time to time. These tests will make sure that this drug is working safely. These tests will check your:

  • cholesterol level
  • kidney function
  • liver function

If you’re a woman of childbearing age, your doctor may also suggest that you a have pregnancy test before you start this drug. (If you become pregnant while taking this drug, your doctor will stop the drug right away.)

Hidden costs

You may have blood tests to make sure this drug is working safely. You may also have pregnancy tests.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.


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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on April 16, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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