Iptacopan
Pronunciation: ip-tah-co-pan
Generic name: iptacopan
Brand name: Fabhalta
Dosage form: oral capsule (200 mg)
Drug class: Selective immunosuppressants
What is iptacopan?
Iptacopan is used to treat paroxysmal nocturnal hemoglobinuria (PNH), primary immunoglobulin A nephropathy (IgAN), or complement 3 glomerulopathy (C3G). It is an oral capsule taken twice a day. The brand name of iptacopan is Fabhalta.
Iptacopan is only available through the Fabhalta (iptacopan) REMS (Risk Evaluation and Mitigation Strategy) program. Your healthcare provider must counsel you about risks, ensure proper vaccinations, give antibiotics if needed, and provide a patient safety card before starting treatment.
The mechanism of iptacopan involves blocking complement factor B, a protein important for red blood cell breakdown. It can prevent RBC destruction, anemia, and kidney damage in conditions such as PNH, IgAN, or C3G. Iptacopan belongs to the drug class called complement factor B inhibitors.
Iptacopan first gained FDA approval on December 5, 2023, under the brand name Fabhalta. There is no generic.
FDA approvals and uses
Iptacopan is approved to treat adults with:
- paroxysmal nocturnal hemoglobinuria (PNH)
- primary immunoglobulin A nephropathy (IgAN) to reduce proteinuria in those at risk of their disease progressing quickly (generally a urine protein-to-creatinine ratio [UPCR] of ≥ 1.5 g/g)
- This approval is under the accelerated approval designation, and continued approval may be contingent upon a clinical benefit being shown in clinical trials.
- complement 3 glomerulopathy (C3G), to reduce proteinuria.
It is not known if Fabhalta is safe and effective in children with PNH, IgAN, or C3G.
Side effects
The most common side effects of iptacopan are:
- a headache
- nasal congestion, runny nose, cough, sneezing, and sore throat (nasopharyngitis)
- diarrhea
- pain in the stomach (abdomen)
- infections (viral and bacterial)
- nausea
- a rash.
Serious side effects and warnings
Iptacopan carries a Boxed Warning for serious infections caused by encapsulated bacteria.
Iptacopan may lower the ability of your immune system to fight infections and increase your risk of serious infections caused by encapsulated bacteria, such as Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type B. These serious infections may quickly become life-threatening or fatal if not recognized and treated early.
- You must complete or be up to date with the vaccines against S. pneumoniae and N. meningitidis at least 2 weeks before your first dose of iptacopan
- If you have not completed your vaccinations and iptacopan must be started right away, you should receive the required vaccinations as soon as possible, and you should also receive antibiotics to take for as long as your healthcare provider tells you
- If you have been vaccinated against these bacteria in the past, you might need additional vaccinations.
Vaccines do not prevent all infections caused by encapsulated bacteria. Call your healthcare provider or get emergency medical care right away if you have any of these signs and symptoms of a serious infection:
- fever (with or without shivers, chills, a rash, chest pain and cough, breathlessness/fast breathing, headache, or high heart rate)
- headache with nausea or vomiting, or stiff neck or stiff back
- confusion
- body aches with flu-like symptoms
- clammy skin
- eyes sensitive to light.
Your healthcare provider will give you a Patient Safety Card about the risk of serious infections. Carry it with you at all times during treatment and for 2 weeks after your last dose of iptacopan. Your risk of serious infections may continue for a few weeks after your last dose of iptacopan. It is important to show this card to any healthcare provider who treats you. This will help them diagnose and treat you quickly.
There is a risk of hemolysis (red blood cell destruction) after stopping iptacopan for PNH. Tell your healthcare provider immediately if you experience any of the following after you have stopped taking iptacopan:
- fatigue
- weakness
- dizziness
- pale skin
- jaundice (yellowing of the skin and eyes)
- dark urine
- rapid heart rate
- shortness of breath
- enlarged spleen.
Iptacopan may increase your cholesterol and triglycerides, and your healthcare provider will do blood tests to check them periodically during treatment.
It is not known if iptacopan is safe and effective in children.
Tell your healthcare provider about any side effect that bothers you or does not go away. These are not all of the possible side effects of iptacopan. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Before taking
Do not take iptacopan if you:
- are allergic to iptacopan or any of the ingredients in Fabhalta. See the end of this guide for a list of ingredients
- have a serious infection when starting treatment
- have severe kidney or liver disease.
Before you take iptacopan, tell your healthcare provider about all of your medical conditions, including if you:
- have an infection or fever
- have kidney or liver problems
- are not up to date with your vaccinations
- have an infection
- are pregnant or plan to become pregnant
- are breastfeeding or plan to breastfeed.
Pregnancy
It is not known if iptacopan will harm your unborn baby.
Breastfeeding
It is not known if iptacopan passes into your breast milk. Do not breastfeed during treatment and for 5 days after your last dose.
How do I take iptacopan?
Take iptacopan exactly as your healthcare provider tells you. Do not change the dose or stop taking it unless your healthcare provider tells you.
- One capsule is taken twice a day.
- Take with or without food.
- Swallow the capsule whole. Do not open, break, or chew.
For people with PNH:
- If you are changing treatment from eculizumab to iptacopan, you should take your starting dose of iptacopan no later than 1 week after your last dose of eculizumab.
- If you are changing treatment from ravulizumab to iptacopan, you should take your starting dose of iptacopan no later than 6 weeks after your last dose of ravulizumab.
Dosing information
Dose of iptacopan for PNH, IgAN, or C3G
- 200 mg (1 capsule) twice daily.
- Take with or without food.
What happens if I miss a dose?
If you miss a dose or doses of iptacopan, take 1 dose as soon as you remember, even if it is almost time to take your next scheduled dose. Then take your next dose of iptacopan at your regularly scheduled time.
What happens if I stop taking iptacopan?
If you have PNH and you stop taking iptacopan, your healthcare provider will need to monitor you closely for at least 2 weeks, because stopping treatment may cause a breakdown of red blood cells due to PNH.
Symptoms or problems that can happen due to the breakdown of red blood cells include:
- decreased hemoglobin level in your blood
- tiredness
- blood in your urine
- pain in the stomach (abdomen)
- shortness of breath
- blood clots, stroke, and heart attack
- trouble swallowing
- erectile dysfunction.
What other drugs affect this medication?
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking iptacopan with certain other medicines may affect the way this medicine works and may cause side effects. Especially tell your healthcare provider if you take:
- CYP2C8 inducers, such as rifampin. These may decrease the effectiveness of iptacopan
- Strong CYP2C8 inhibitors, such as gemfibrozil. These may increase the blood levels of iptacopan.
Know the medicines you take and the vaccines you receive. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine. See the Fabhalta Prescribing Information for a list of interactions.
Storage
Store iptacopan at room temperature between 68°F to 77°F (20°C to 25°C).
Keep out of the reach of children.
Ingredients
Iptacopan is only available as the brand Fabhalta.
Active ingredient: iptacopan 200mg
Inactive ingredients, capsule shell: gelatin, red ferric oxide, titanium dioxide, yellow ferric oxide.
Black printing ink: ferrosoferric oxide, potassium hydroxide, propylene glycol, shellac, and strong ammonia solution.
Who makes iptacopan?
Iptacopan is made and distributed by Novartis Pharmaceuticals under the brand name Fabhalta. Novartis is located in East Hanover, New Jersey.
References
More about iptacopan
- Check interactions
- Compare alternatives
- Side effects
- Dosage information
- During pregnancy
- Drug class: selective immunosuppressants
- Breastfeeding
- En español
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Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.