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mavacamten

Cardiac myosin inhibitor · Agent for hypertrophic cardiomyopathy

Cardiac myosin inhibitorAgent for hypertrophic cardiomyopathy
CDSCO approved
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
not curated

Mechanism

Mavacamten is an allosteric and reversible inhibitor selective for cardiac myosin. It reduces the number of myosin heads that can enter 'on actin' (power-generating) states, thus reducing force-producing and residual cross-bridge formation, directly targeting sarcomeric hypercontractility in HCM.

Indications

symptomatic obstructive hypertrophic cardiomyopathy (HCM)

Dosing

Renal adjustment
Closely monitored.
Hepatic adjustment
Closely monitored.

Pharmacokinetics

Half-life
6-9 days (normal metabolizers); 23 days (CYP2C19 poor metabolizers)
Metabolism
Extensively metabolized, primarily through CYP2C19.

Contraindications

  • left ventricular ejection fraction below 50%

Side effects

Serious
  • heart failure

Drug interactions

Antidepressants
Moderate
Textbook

Increased mavacamten serum concentrations, increasing the risk of negative inotropic effects and heart failure.

Patients receiving mavacamten must be closely monitored.

Source: G&G 14e · p663

Fluconazole
Moderate
Textbook

Increased mavacamten serum concentrations, increasing the risk of negative inotropic effects and heart failure.

Patients receiving mavacamten must be closely monitored.

Source: G&G 14e · p663

Related guidelines

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Continue into a citation-backed clinical answer with the drug context already attached.

Sources: Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team