Oral plasma kallikrein inhibitor
Berotralstat
Brand names: Orladeyo
Adult dose
Dose: 150mg PO OD
Route: Oral
Frequency: OD with food
Clinical pearls
- NICE TA738: prophylaxis of hereditary angioedema (HAE) attacks
- UK PIN HAE guidance; alternative to lanadelumab SC
- Specialist immunology centre
Contraindications
- Severe hepatic impairment
- Concurrent strong P-gp/BCRP substrates
- Hypersensitivity
Side effects
- Abdominal pain
- Diarrhoea
- Headache
- Reflux
- QT prolongation
- Hepatic enzyme elevation
Interactions
- P-gp / BCRP substrates
- Strong CYP3A4 inducers
- QT-prolonging drugs
Monitoring
- Attack frequency
- LFTs
- ECG (QT)
- Adherence
Reference: BNF; NICE TA738; UK PIN HAE; SmPC; https://bnf.nice.org.uk/drugs/berotralstat/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- DOAC Score for Selecting Direct Oral Anticoagulant in Non-Valvular AF · Anticoagulation
- 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
Pathways
- Sepsis Screening and Sepsis Six · UK Sepsis Trust; NICE NG51; Surviving Sepsis Campaign 2021
- Unintentional Weight Loss Workup · NICE NG12; BSG
- Chronic Fatigue Workup · NICE NG206; BMJ Best Practice
- Lymphadenopathy Workup · NICE NG12; BMJ Best Practice
- Pre-op Medical Clearance · NICE NG45; ESC 2022
- Secondary Hypertension Workup · NICE NG136; ESH 2023