MTP inhibitor
Lomitapide
Brand names: Lojuxta
Adult dose
Dose: 5mg PO OD initially, titrate to max 60mg OD
Route: PO
Frequency: OD
Clinical pearls
- Homozygous familial hypercholesterolaemia adjunct; specialist lipid clinic
- Daily fat-soluble vitamin supplement; LFTs every dose change
Contraindications
- Pregnancy
- Moderate-severe hepatic impairment
- Concurrent moderate/strong CYP3A4 inhibitors
Side effects
- Hepatic steatosis
- Hepatotoxicity (raised transaminases — black box)
- GI upset / diarrhoea
- Reduced fat-soluble vitamin absorption
Interactions
- Strong/moderate CYP3A4 inhibitors (avoid)
- Bile acid sequestrants (separate ≥4h)
- Warfarin
- Statins (raise levels — limit dose)
Monitoring
- LFTs
- Lipids
- Pregnancy testing
Reference: BNF; NICE TA1015; SmPC; https://bnf.nice.org.uk/drugs/lomitapide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines