Features and properties of maralixibat

Alternative names	Maralixibat chloride; Livmarli™; CAN 108; lopixibat; lopixibat chloride; LUM-001; SD-5613; SHP 625
Classes	Amines; anti-inflammatories; antihyperlipidaemics; azabicyclo compounds; benzothiepins; dioxoles; hepatoprotectants; onium compounds; small molecules
Mechanism of action	Sodium-bile acid cotransporter inhibition
Route of administration	Oral
Pharmacodynamics	Inhibits the ileal bile acid transporter, resulting in decreased reabsorption of bile acids from the terminal ileum and reductions in serum bile acid levels; may reduce absorption of fat-soluble vitamins
Pharmacokinetics	Minimal absorption; approximately dose-proportional exposure; 91% bound to human plasma proteins in vitro; limited metabolism; mean half-life of 1.6 h; excretion is predominantly (73%) through the faecal route, mostly as unchanged maralixibat
Most common adverse events	Diarrhoea, abdominal pain, vomiting, fat-soluble vitamin deficiency, transaminases increased, gastrointestinal bleeding
ATC codes
WHO ATC code	A05A-X04 (maralixibat chloride)
EphMRA ATC code	A5A (Bile Therapy and Cholagogues)
Chemical name	1-{[4-({4-[(4R,5R)-3,3-dibutyl-7-(dimethylamino)-4-hydroxy-1,1-dioxo-2,3,4,5-tetrahydro-1H-1λ6-benzothiepin-5-yl]phenoxy}methyl)phenyl]methyl}-1,4-diazabicyclo[2.2.2]octan-1-ium chloride