Features and properties of mavacamten

Alternative names	Camzyos; HCM 1; MAVA-Bristol Myers Squibb/MyoKardia; MYK-461; SAR-439152
Class	Cardiovascular therapies; Ethylamines; Heart failure therapies; Pyrimidinones; Small molecules
Mechanism of action	Cardiac myosin inhibitors
Route of administration	Oral
Pharmacodynamics	Stabilizes cardiac myosin; decreases the number of myosin heads that can enter “on actin” states and reduces the probability of systolic and diastolic cross-bridge formation. Reduces LVOT obstruction, LV mass, LA volume and NT-proBNP levels
Pharmacokinetics	Median Tmax 1 h, 97–98% plasma protein bound. Extensively metabolized in the liver, primarily via CYP2C19 (74%), CYP3A4 (18%) and CYP2C9 (8%); elimination depends on polymorphic CYP2C19 status (mean AUC∞ ↑241%, mean Cmax ↑ 47%, t1/2 ↑ to 23 days in CYP2C19 poor metabolizers). Mainly excreted in urine
Adverse events
Most frequent	Dizziness, syncope
Occasional	Reversible ↓ in LVEF to < 50%
ATC codes
WHO ATC code	C01E-B24 (Mavacamten)
EphMRA ATC code	C1 (Cardiac Therapy)
Chemical name	3-(1-methylethyl)-6-[[(1S)-1-phenylethyl]amino]-2,4(1H,3H)-pyrimidinedione