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
Drug reference
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
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
Hypertrophic cardiomyopathy
ESC · Cardiology · 2026
Preoperative cardiac evaluation for non-cardiac surgery
AHA · Cardiology · 2025
Chronic obstructive pulmonary disease
GOLD · Pulmonology · 2025
Heart failure in diabetes
RSSDI · Cardiology · 2023
Chronic obstructive pulmonary disease
ICS · Pulmonology · 2022
Ask House about mavacamten
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Textbook-sourced·Sources: Goodman & Gilman 14e·Updated: 2026-05-10