Juxtapid (Lomitapide) belongs to the class of medications called triglyceride transfer protein inhibitors. It is used, in addition to a low-fat diet and other lipid lowering medications, to reduce the amount of LDL cholesterol ("bad" cholesterol) in the blood, for adults who have a genetic condition called homozygous familial hypercholesterolemia (HoFH) that causes the body to produce too much LDL cholesterol.

In the liver and gut cells, fatty substances are built into larger fat particles that are then released into the blood stream. Juxtapid (Lomitapide) works by blocking the production of these larger particles, reducing the amount of cholesterol in the blood.

Juxtapid (Lomitapide) may be available under multiple brand names and/or in several different forms. Any specific brand name of Juxtapid (Lomitapide) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Juxtapid (Lomitapide) may not be used for all of the conditions discussed here.

Your doctor may have suggested Juxtapid (Lomitapide) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Juxtapid (Lomitapide), speak to your doctor. Do not stop taking Juxtapid (Lomitapide) without consulting your doctor.

Do not give Juxtapid (Lomitapide) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Juxtapid (Lomitapide) if their doctor has not prescribed it.

The recommended starting dose of Juxtapid (Lomitapide) for adults is 5 mg taken once daily. After 2 weeks, the dose can be increased to 10 mg taken once daily. If necessary, the dose can be increased at 4 week intervals as it is tolerated. The maximum recommended dose is 60 mg daily.

Juxtapid (Lomitapide) capsules should be swallowed whole with a glass of water. Do not open, crush, dissolve, or chew the capsules.

Food may cause side effects such as nausea and Diarrhea, therefore, Juxtapid (Lomitapide) should be taken without food, at least 2 hours after the evening meal.

Your doctor may also prescribe Vitamin E and essential fatty acids for you to take while you are taking Juxtapid (Lomitapide).  These supplements should not be taken within 2 hours of Juxtapid (Lomitapide). It is recommended that these dietary supplements be taken in the morning.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Juxtapid (Lomitapide) exactly as prescribed by your doctor.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Juxtapid (Lomitapide) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Juxtapid (Lomitapide). If you are concerned about side effects, discuss the risks and benefits of Juxtapid (Lomitapide) with your doctor.

The following side effects have been reported by at least 1% of people taking Juxtapid (Lomitapide). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• belching/burping
• decreased appetite
• diarrhea
• gas
• hair loss
• heartburn
• nausea
• stomach cramping or pain
• vomiting
• weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• signs of muscle breakdown (e.g., unexplained muscle pain or spasm, muscle cramps, dark brown urine)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• severe diarrhea causing lightheadedness, decreased urine output or tiredness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Juxtapid (Lomitapide).

5 mg
Each orange, hard gelatin capsule, printed with black ink "A733" and "5 mg", contains 6 mg of Juxtapid (Lomitapide) mesylate equivalent to 5 mg free base. Nonmedicinal ingredients: gelatin, lactose white monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, red iron oxide, silicon dioxide, sodium starch glycolate, and titanium dioxide.

10 mg
Each orange/white, hard gelatin capsule, printed with black ink "A733" and "10 mg", contains 11 mg of Juxtapid (Lomitapide) mesylate equivalent to 10 mg free base. Nonmedicinal ingredients: gelatin, lactose white monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, red iron oxide, silicon dioxide, sodium starch glycolate, and titanium dioxide.

20 mg
Each white, hard gelatin capsule, printed with black ink "A733" and "20 mg", contains 23 mg of Juxtapid (Lomitapide) mesylate equivalent to 20 mg free base. Nonmedicinal ingredients: gelatin, lactose white monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, silicon dioxide, sodium starch glycolate, and titanium dioxide.

Do not take Juxtapid (Lomitapide) if you:

• are allergic to Juxtapid (Lomitapide) or any ingredients of the medication
• have moderate-to-severe liver impairment
• have chronic bowel disease, such as inflammatory bowel disease or malabsorption
• are using any of the following medications:
• "azole" antifungals (e.g., fluconazole, itraconazole, Voriconazole)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• HIV protease inhibitors (e.g., lopinavir, ritonavir, saquinavir)
• nefazodone
• Dronedarone
• Simvastatin doses larger than 20 mg
• are or may be pregnant
• have one of the following rare hereditary diseases:
• galactose intolerance
• Lapp-lactase deficiency
• glucose-galactose malabsorption

There may be an interaction between Juxtapid (Lomitapide) and any of the following:

• Acetaminophen
• alcohol
• Amiodarone
• Aprepitant
• Aripiprazole
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, voriconazole)
• barbiturates (e.g., pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Chlordiazepoxide, Clonazepam, Diazepam, Lorazepam)
• Bicalutamide
• birth control pills
• Bosentan
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• Carbamazepine
• Cholestyramine
• Cimetidine
• ciprofloxacin
• Cobicistat
• Colchicine
• Colesevelam
• Colestipol
• conivaptan
• Cyclosporine
• dabigatran
• Danazol
• dabigatran
• Deferasirox
• Desipramine
• Dexamethasone
• Digoxin
• dofetilide
• dronedarone
• Enzalutamide
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• ezetimbe
• fenfibrate
• Everolimus
• "gliptin" Diabetes medications (e.g., Linagliptin, Saxagliptin, Sitagliptin)
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Hydrocodone
• isoniazid
• Ivacaftor
• Lurasidone
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• maraviroc
• Methotrexate
• mifepristone
• Mitotane
• Modafinil
• nefazodone
• Phenytoin
• Pimozide
• primidone
• quinidine
• Ranitidine
• rifabutin
• rifampin
• Sarilumab
• St. John's wort
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• Seville oranges
• siltuximab
• Sirolimus
• "statin" anti-cholesterol medications (e.g., Atorvastatin, Lovastatin, simvastatin)
• Stiripentol
• Tamoxifen
• Tetracycline
• Ticagrelor
• Tocilizumab
• Tolvaptan
• tretinoin
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, desipramine, Trimipramine)
• tyrosine kinase inhibitors (e.g., Dasatinib, imatinib, Pazopanib)
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Juxtapid (Lomitapide). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.