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Overview: Juxtapid is used to treat homozygous familial hypercholesterolemia (HoFH), a rare genetic condition that causes very high cholesterol levels. Common side effects include digestive issues, such as diarrhea, nausea, vomiting, and upset stomach. Serious side effects include liver problems. Call your health care provider right away if you have unusual tiredness, light-colored poop, dark-colored pee, or yellowing of the skin or the whites of your eyes. Because of this risk, Juxtapid is only available through a special program and can only be prescribed and dispensed by certified health care providers and pharmacies.

Uses

What is Juxtapid used for?

Juxtapid (lomitapide) is commonly used to treat homozygous familial hypercholesterolemia (HoFH). This is a rare genetic condition that reduces the body’s ability to remove “bad” cholesterol (also called LDL cholesterol) from the blood. This leads to very high cholesterol levels, which increases the risk of heart disease and problems, such as heart attacks, at an early age.

Juxtapid may also be used for other conditions as determined by your health care provider.

How does Juxtapid work (mechanism of action)?

Juxtapid blocks a protein in your gut and liver that helps make and transport certain fatty molecules into the blood. This lowers cholesterol levels and helps manage homozygous familial hypercholesterolemia.

How is Juxtapid supplied (dosage forms)?

Brands and other names

  • Juxtapid

Dosage forms and strengths

  • 5 mg oral capsules
  • 10 mg oral capsules
  • 20 mg oral capsules
  • 30 mg oral capsules

How should I store Juxtapid?

Juxtapid should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from moisture. Keep the container tightly closed.

Side Effects

What are the most common side effects of Juxtapid?

The most common side effects of Juxtapid are listed below. Tell your health care provider if you have any of these side effects that bother you. See the Serious Side Effects section below for more information.

  • Diarrhea
  • Nausea and vomiting
  • Upset stomach
  • Stomach pain
  • Gas 
  • Constipation

There may be other side effects of Juxtapid that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Juxtapid?

While less common, the most serious side effects of Juxtapid are described below, along with what to do if they happen.

Severe Allergic Reactions. Juxtapid may cause allergic reactions, which can be serious. Stop taking Juxtapid and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Liver Problems. Juxtapid may cause increased levels of liver enzymes or fatty liver disease. These could be signs of liver damage (also called hepatotoxicity) or may increase the risk of serious liver problems. Keep all appointments, including for blood tests, before and while taking Juxtapid. Call your health care provider right away if you have any of the following symptoms of liver problems.

  • Nausea, vomiting, or stomach or belly pain that is worse than usual or does not go away
  • Fever or flu-like symptoms
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Digestive Side Effects. Juxtapid commonly causes digestive side effects, such as diarrhea, nausea, vomiting, upset stomach, and stomach pain. These side effects can sometimes be severe. Diarrhea or vomiting may also make other medicines you take by mouth not work as well. If you have these side effects, talk with your health care provider. Stop taking Juxtapid and tell your health care provider right away if you have any severe side effects or you notice any signs of dehydration, such as lightheadedness, decreased amount of pee, or tiredness.

Warnings & Precautions

Who should not use Juxtapid?

Allergies to Ingredients. People who are allergic to any of the following should not take Juxtapid.

  • Juxtapid
  • Lomitapide
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Juxtapid.

Pregnancy. Do not take Juxtapid if you are pregnant. If you become pregnant, contact your health care provider right away. See the Pregnancy section for more details.

Drug Interactions. Juxtapid should not be taken while you are using certain other medicines. Before taking Juxtapid, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Liver Problems. Juxtapid should not be used if your liver is not working as well as it should be or if you have certain liver problems. If there is a concern about the health of your liver, your health care provider may do tests to determine if it is working well enough to take this medicine.

What should I know about Juxtapid before using it?

Do not take Juxtapid unless it has been prescribed to you by a health care provider. Take it as prescribed. Follow any instructions from your health care provider about changes to your diet or other medicines you should take while taking Juxtapid.

Do not share Juxtapid with other people, even if they have the same condition as you. It may harm them.

Keep Juxtapid out of the reach of children.

Juxtapid is only available through a special program because of the risk of liver problems. It can only be prescribed and dispensed by certified health care providers and pharmacies. It is important that you keep all of your appointments, including lab or other tests, before starting and while taking Juxtapid. If you have any questions about this program you can go to www.juxtapid.com/rems or call 855-898-2743.

Swallow Juxtapid whole with a glass of water. Do not open, crush, dissolve, or chew the capsules.

Juxtapid can make you less able to absorb certain nutrients. Follow all instructions given by your health care provider about any vitamins or supplements you should take while you are taking Juxtapid. 

There is a registry that collects information about the effects of taking Juxtapid for a long time. Participation is voluntary. For more information, talk with your health care provider, visit www.juxtapid.com, or call 877-902-4099.

What should I tell my health care provider before using Juxtapid?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Juxtapid is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Problems with your digestive tract or pancreas, or if you have any problems absorbing nutrients
  • Kidney problems

Galactose Intolerance. Tell your health care provider if you have a genetic condition that makes you intolerant of certain types of sugar, including galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption. People with these conditions may be more likely to have diarrhea when taking Juxtapid.

Pregnancy. Do not take Juxtapid if you are pregnant. Juxtapid may cause harm to the fetus. Tell your health care provider if you are pregnant, think you are pregnant, or plan to become pregnant. You should not be pregnant before starting Juxtapid. If you can become pregnant, you should use effective birth control while taking Juxtapid and for two weeks after your last dose. If you are taking a birth control pill and have diarrhea or vomiting, talk with your health care provider. You may need to use backup birth control. 

If you become pregnant, stop taking Juxtapid right away and contact your health care provider. If you become pregnant while taking Juxtapid, you can also sign up for the Juxtapid Pregnancy Exposure Registry by calling 877-902-4099 or at www.juxtapid.com. This registry collects safety information about the use of Juxtapid during pregnancy.

Breastfeeding. It is not known if Juxtapid passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop Juxtapid.

How can I get more information about Juxtapid?

For more information about Juxtapid, you can visit the drugmaker’s website at www.juxtapid.com or call them at 855-898-2743.

Interactions

Does Juxtapid interact with foods or drinks?

Juxtapid should not be taken with food. Taking Juxtapid with food can increase the risk of stomach problems. Take Juxtapid at least two hours after the evening meal. 

Eating grapefruit or drinking grapefruit juice while taking Juxtapid can increase the risk of side effects. Avoid products containing grapefruit while taking Juxtapid.

Drinking alcohol while taking Juxtapid may increase the risk of liver problems. Do not have more than one alcoholic drink per day while you are taking Juxtapid. 

Does Juxtapid interact with other medicines (drug interactions)?

Juxtapid interacts with many other medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Juxtapid.

  • Warfarin, which is a blood thinner
  • A statin, such as atorvastatin (Lipitor and others), lovastatin, or simvastatin, which is a medicine to lower cholesterol
  • A bile acid sequestrant, such as cholestyramine (Prevalite), colesevelam (Welchol), or colestipol (Colestid), which is a medicine to lower cholesterol
  • A medicine for bacterial, fungal, or viral infections (including for HIV or hepatitis C)
  • An antidepressant
  • A medicine for high blood pressure
  • A medicine for chest pain (angina)
  • A birth control pill

Many other medicines may alter the blood levels of Juxtapid, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Juxtapid. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Juxtapid?

If you or someone else has used too much Juxtapid, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Juxtapid?

If you miss a dose, skip the missed dose and only take the next dose at the usual time. Do not take double or extra doses. If you missed taking Juxtapid for more than one week, contact your health care provider for advice.