Skip to main content

Lomitapide (Monograph)

Brand name: Juxtapid
Drug class:

Medically reviewed by Drugs.com on Apr 10, 2024. Written by ASHP.

Warning

Risk Evaluation and Mitigation Strategy (REMS):

FDA approved a REMS for lomitapide to ensure that the benefits outweigh the risks. The REMS may apply to one or more preparations of lomitapide and consists of the following: elements to assure safe use and implementation system. See https://www.accessdata.fda.gov/scripts/cder/rems/. Also see Restricted Distribution Program under Dosage and Administration.

Warning

    Hepatotoxicity
  • Increases in serum aminotransferase (ALT and/or AST) concentrations and/or hepatic steatosis reported; hepatic steatosis is a risk factor for progressive liver disease, including steatohepatitis and cirrhosis. (See Hepatotoxicity under Cautions.)

  • Monitor liver function laboratory tests prior to initiation of therapy, prior to any increase in dosage, and at recommended intervals during therapy. If hepatotoxicity occurs, interrupt therapy, reduce dosage, or discontinue lomitapide depending on severity and persistence of toxicity. (See Hepatotoxicity under Dosage and Administration.)

    Restricted Distribution Program
  • Available only through the Juxtapid REMS program. (See REMS and also see Restricted Distribution Program under Dosage and Administration.)

Introduction

Antilipemic agent; microsomal triglyceride transfer protein (MTTP) inhibitor.

Uses for Lomitapide

Dyslipidemias

Adjunct to a low-fat diet and other lipid-lowering treatments, including LDL apheresis where available, to reduce LDL-cholesterol, total cholesterol, apolipoprotein B (apo B), and non-HDL-cholesterol concentrations in the management of homozygous familial hypercholesterolemia (designated an orphan drug by US FDA for use in this condition).

Safety and efficacy not established in patients with hypercholesterolemia who do not have homozygous familial hypercholesterolemia.

Effects on cardiovascular morbidity and mortality not established.

Lomitapide Dosage and Administration

General

Restricted Distribution Program

Administration

Oral Administration

Administer orally once daily without food, ≥2 hours after evening meal.

Swallow capsules whole with a glass of water; do not open, crush, dissolve, or chew.

If a dose is missed, take next dose at regularly scheduled time. If therapy is interrupted for >1 week, contact healthcare provider prior to reinitiation of therapy.

Dosage

Available as lomitapide mesylate; dosage expressed in terms of lomitapide.

Adults

Dyslipidemias
Homozygous Familial Hypercholesterolemia
Oral

Initially, 5 mg once daily. Continue initial dosage for ≥2 weeks.

After receiving initial dosage for ≥2 weeks, may increase dosage gradually (i.e., at intervals of ≥4 weeks) in stepwise manner (i.e., to 10, 20, 40, and then 60 mg daily) based on safety and tolerability.

Maintenance dosage should be individualized, taking into account patient's goals and response to therapy. (See Prescribing Limits under Dosage and Administration.)

Dosage Modification
Hepatotoxicity

If hepatotoxicity occurs, reduce lomitapide dosage, or interrupt or permanently discontinue therapy and investigate probable cause. (See Table 1.)

Table 1. Recommended Dosage Modifications for Hepatotoxicity1

ALT or AST Concentrations

Treatment and Monitoring Recommendations

3 to <5 times the ULN

Repeat ALT and AST measurement within 1 week; if ALT or AST concentration remains elevated, reduce dosage and obtain additional liver function tests (e.g., alkaline phosphatase, total bilirubin, INR) if not already measured

Repeat liver function tests weekly; withhold lomitapide if signs of abnormal liver function (e.g., increased bilirubin concentrations or INR) are present, ALT or AST concentrations increase to >5 times the ULN, or ALT or AST concentrations do not decrease to <3 times the ULN within 4 weeks; investigate probable cause of persistent or worsening liver function abnormalities

If therapy is resumed (after ALT or AST concentrations have decreased to <3 times the ULN), consider reducing lomitapide dosage and monitor liver function tests more frequently

≥5 times the ULN

Withhold lomitapide, obtain additional liver function tests (e.g., alkaline phosphatase, total bilirubin, INR) if not already measured, and investigate probable cause

If therapy is resumed (after ALT or AST concentrations have decreased to <3 times the ULN), reduce lomitapide dosage and monitor liver function tests more frequently

Serum ALT or AST elevations accompanied by clinical symptoms of liver injury (e.g., nausea, vomiting, abdominal pain, fever, jaundice, lethargy, flu-like symptoms), bilirubin concentration ≥2 times the ULN, or active liver disease

Discontinue lomitapide and investigate probable cause

Concomitant Use with CYP3A4 Inhibitors

Concomitant use with moderate or potent CYP3A4 inhibitors is contraindicated. (See Interactions.)

Do not exceed lomitapide dosage of 30 mg daily when used concomitantly with weak CYP3A4 inhibitors.

Prescribing Limits

Adults

Homozygous Familial Hypercholesterolemia
Oral

Maximum 60 mg daily.

Special Populations

Hepatic Impairment

Mild hepatic impairment (Child-Pugh class A): Do not exceed 40 mg daily. (See Hepatic Impairment under Cautions.)

Moderate or severe hepatic impairment (Child-Pugh class B or C): Use is contraindicated.

Renal Impairment

End-stage renal disease requiring dialysis: Do not exceed 40 mg daily. (See Renal Impairment under Cautions.)

Renal impairment or end-stage renal disease not requiring dialysis: Not studied.

Geriatric Patients

Select dosage with caution because of possible age-related decreases in hepatic, renal, or cardiac function and of concomitant disease or other drug therapy.

Cautions for Lomitapide

Contraindications

Warnings/Precautions

Warnings

Hepatotoxicity

Increases in serum aminotransferase (ALT and/or AST) concentrations reported; persistent and severe (≥10 times the ULN) elevations also reported. No concomitant or subsequent clinically meaningful elevations in bilirubin, INR, or alkaline phosphatase concentrations. Serum aminotransferase concentrations typically declined within 1–4 weeks following reduction in lomitapide dosage or interruption of therapy.

Hepatic steatosis, with or without concomitant increases in serum aminotransferase concentrations, reported. May be reversible following discontinuance of therapy; however, not known whether histologic sequelae remain, particularly after long-term therapy. Hepatic steatosis is a risk factor for progressive liver disease, including steatohepatitis and cirrhosis. Long-term consequences of hepatic steatosis associated with lomitapide therapy unknown. However, there is concern that lomitapide-induced hepatic steatosis could result in steatohepatitis, which can progress to cirrhosis over several years.

Hepatic dysfunction (elevated aminotransferase concentrations with increases in bilirubin concentrations or INR) or hepatic failure not reported.

Perform liver function tests (i.e., ALT, AST, alkaline phosphatase, and total bilirubin concentrations) prior to initiation of therapy; evaluate and manage abnormal concentrations before initiating therapy. During first year of therapy, perform liver function tests (or, at a minimum, ALT and AST concentrations) prior to each increase in dosage or monthly, whichever occurs first. After first year of therapy, perform liver-related tests at least every 3 months and prior to any increase in dosage. If elevations in aminotransferase concentrations occur, reduce lomitapide dosage; if persistent or clinically relevant elevations are observed, interrupt or permanently discontinue therapy and investigate probable cause. (See Hepatotoxicity under Dosage and Administration.)

Alcohol may increase levels of hepatic fat and induce or exacerbate liver injury. Advise patients to limit alcohol consumption to ≤1 alcohol-containing drink per day.

Exercise caution when used concomitantly with other potentially hepatotoxic drugs. Concomitant use with other LDL-lowering agents known to increase hepatic fat not recommended. (See Hepatotoxic Drugs under Interactions.)

Other Warnings and Precautions

Juxtapid Registry

A registry has been established to monitor and evaluate the long-term effects of lomitapide. Information available at 877-902-4099 or at [Web].

Fetal/Neonatal Morbidity and Mortality

May cause fetal harm; teratogenicity demonstrated in animals.

Exclude pregnancy prior to initiation of therapy. Advise women of childbearing potential to use an effective method of contraception during therapy. If oral contraceptives are used, do not exceed lomitapide dosage of 30 mg daily. If incomplete absorption of oral contraceptives occurs (e.g., resulting from lomitapide-induced vomiting and diarrhea), may need to use additional contraceptive methods.

If used during pregnancy or if patient becomes pregnant during therapy, discontinue therapy and apprise of potential fetal hazard. (See Advice to Patients.)

Fat-soluble Vitamin and Fatty Acid Deficiency

May reduce absorption of fat-soluble vitamins and serum fatty acids and increase risk of developing fat-soluble nutrient deficiency. Patients predisposed to malabsorption (e.g., those with chronic bowel or pancreatic diseases) may be at increased risk.

Manufacturer recommends use of supplements containing 400 units of vitamin E and at least 210 mg of alpha-linolenic acid, 200 mg of linoleic acid, 110 mg of EPA, and 80 mg of DHA during therapy.

GI Effects

Adverse GI effects, including diarrhea, nausea, dyspepsia, and vomiting frequently observed. Abdominal pain, abdominal discomfort, abdominal distention, constipation, and flatulence also reported. Absorption of concomitantly used oral medications may be affected in patients who develop diarrhea or vomiting during therapy.

To reduce to risk of adverse GI effects, increase dosage gradually and instruct patients to adhere to a low-fat diet (i.e., <20% of total calories from fat) and to take lomitapide without food (≥2 hours after evening meal).

Concomitant Use with CYP3A4 Inhibitors

Concomitant use with CYP3A4 inhibitors may increase exposure to lomitapide.

Concomitant use with moderate or potent CYP3A4 inhibitors is contraindicated. (See Contraindications under Cautions.) If used concomitantly with a weak CYP3A4 inhibitor, do not exceed lomitapide dosage of 30 mg daily. (See Specific Drugs and Foods under Interactions.)

Concomitant Use with Hydroxymethylglutaryl CoA (HMG-CoA) Reductase Inhibitors (Statins)

Concomitant use with certain statins that are metabolized by CYP3A4 (e.g., simvastatin, lovastatin) may result in increased exposure to the statin and possible increased risk of myopathy, including rhabdomyolysis. (See Specific Drugs and Foods under Interactions.)

Concomitant Use with Warfarin

Increases in lomitapide dosage may lead to supratherapeutic anticoagulation with warfarin, and decreases in lomitapide dosage may lead to subtherapeutic anticoagulation. Monitor INR regularly, especially following any changes to lomitapide dosage, and adjust warfarin dosage as clinically indicated. (See Specific Drugs and Foods under Interactions.)

Patients with Hereditary Disorders

Possible diarrhea and malabsorption in patients with rare hereditary disorders, including galactose intolerance, the Lapp lactase deficiency, and glucose-galactose malabsorption; avoid use in such patients.

Specific Populations

Pregnancy

Category X. (See Contraindications and also Fetal/Neonatal Morbidity and Mortality under Cautions.)

Pregnancy registry at 877-902-4099 or [Web] to monitor pregnancy outcomes in women who have been exposed to lomitapide.

Lactation

Not known whether distributed into human milk; discontinue nursing or the drug.

Pediatric Use

Safety and efficacy not established in pediatric patients.

Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether they respond differently than younger adults. Other reported clinical experience has not identified differences in responses between geriatric and younger patients. Select dosage with caution. (See Geriatric Patients under Dosage and Administration.)

Hepatic Impairment

Increased systemic exposure in patients with mild or moderate hepatic impairment (Child-Pugh class A or B). (See Special Populations under Pharmacokinetics.) Not studied in patients with severe hepatic impairment (Child-Pugh class C).

Do not exceed lomitapide dosage of 40 mg daily in patients with mild hepatic impairment (Child-Pugh class A).

Use contraindicated in patients with moderate or severe hepatic impairment (Child-Pugh class B or C).

Renal Impairment

Increased systemic exposure in patients with end-stage renal disease undergoing dialysis; do not exceed lomitapide dosage of 40 mg daily. (See Special Populations under Pharmacokinetics.)

Not studied in patients with mild, moderate, or severe renal impairment or in patients with end-stage renal disease not requiring dialysis.

Common Adverse Effects

Diarrhea, nausea, dyspepsia, vomiting, abdominal pain, weight loss, chest pain, abdominal discomfort, abdominal distention, constipation, flatulence, influenza, nasopharyngitis, increased ALT, fatigue, gastroenteritis, back pain, pharyngolaryngeal pain, gastroesophageal reflux disease, defecation urgency, rectal tenesmus, fever, headache, dizziness, nasal congestion, angina pectoris, palpitations.

Drug Interactions

Metabolized principally by CYP3A4; also may be metabolized to a small extent by CYP isoenzymes 1A2, 2B6, 2C8, and 2C19.

Inhibits CYP3A4 but does not inhibit CYP isoenzymes 1A2, 2B6, 2C9, 2C19, 2D6, or 2E1.

Does not induce CYP isoenzymes 1A2, 3A4, or 2B6.

Inhibitor, but not a substrate, of P-glycoprotein (P-gp).

Does not inhibit breast cancer resistance protein (BCRP).

Drugs and Foods Affecting Hepatic Microsomal Enzymes

Moderate or potent CYP3A4 inhibitors: Possible increased exposure to lomitapide. Concomitant use contraindicated. If concomitant use cannot be avoided, interrupt lomitapide therapy during therapy with the CYP3A4 inhibitor. (See Specific Drugs and Foods under Interactions.)

Weak CYP3A4 inhibitors: Possible increased exposure to lomitapide. If used concomitantly, do not exceed lomitapide dosage of 30 mg daily. (See Specific Drugs and Foods under Interactions.)

Drugs Affected by P-glycoprotein Transport

Substrates of P-gp: Possible increased absorption of P-gp substrate. If used concomitantly, consider dosage reduction of P-gp substrate. (See Specific Drugs and Foods under Interactions.)

Hepatotoxic Drugs

Possible increased risk of hepatotoxicity. Use concomitantly with caution; more frequent monitoring of liver-related tests may be warranted. (See Specific Drugs and Foods under Interactions.)

Concomitant use with other LDL-lowering agents known to increase hepatic fat not studied; therefore, such concomitant use not recommended.

Specific Drugs and Foods

Drug or Food

Interaction

Comments

Acetaminophen (>4 g daily for ≥3 days per week)

Possible increased risk of hepatotoxicity

Use concomitantly with caution; more frequent monitoring of liver-related tests may be warranted

Alcohol

Possible increased levels of hepatic fat; may induce or exacerbate liver injury

Limit alcohol consumption to ≤1 alcohol-containing drink per day

Aliskiren

Possible increased aliskiren absorption

Consider reducing aliskiren dosage

Alprazolam

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Ambrisentan

Possible increased ambrisentan absorption

Consider reducing ambrisentan dosage

Amiodarone

Possible increased lomitapide exposure; possible increased risk of hepatotoxicity

Use concomitantly with caution and do not exceed lomitapide dosage of 30 mg daily; more frequent monitoring of liver function tests may be warranted

Amlodipine

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Antidepressants, SSRIs (fluoxetine, fluvoxamine)

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Antidiabetic agents, dipeptidyl peptidase-4 (DPP-4) inhibitors (saxagliptin, sitagliptin)

Possible increased absorption of DPP-4 inhibitor

Consider reducing dosage of DPP-4 inhibitor

Antifungals, azoles (fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole)

Possible increased lomitapide exposure

Ketoconazole: Substantial increases in peak plasma concentration and AUC of lomitapide

Posaconazole: Possible increased lomitapide exposure; possible increased posaconazole absorption

Concomitant use contraindicated; if concomitant use is unavoidable, interrupt lomitapide therapy during antifungal treatment

Antiretrovirals, HCV protease inhibitors (boceprevir, telaprevir)

Possible increased lomitapide exposure

Concomitant use contraindicated

Antiretrovirals, HIV protease inhibitors (atazanavir, darunavir/ritonavir, fosamprenavir, indinavir, lopinavir/ritonavir, nelfinavir, ritonavir, saquinavir, tipranavir/ritonavir)

Possible increased lomitapide exposure

Concomitant use contraindicated

Aprepitant

Possible increased lomitapide exposure

Concomitant use contraindicated; if concomitant use is unavoidable, interrupt lomitapide therapy during aprepitant treatment

Bicalutamide

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Bile acid sequestrants

Possible decreased lomitapide absorption

Administer lomitapide ≥4 hours apart from bile acid sequestrant

Calcium-channel blocking agents, nondihydropyridine (diltiazem, verapamil)

Possible increased lomitapide exposure

Concomitant use contraindicated

Cilostazol

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Ciprofloxacin

Possible increased lomitapide exposure

Concomitant use contraindicated; if concomitant use is unavoidable, interrupt lomitapide therapy during ciprofloxacin treatment

Colchicine

Possible increased colchicine absorption

Consider reducing colchicine dosage

Conivaptan

Possible increased lomitapide exposure

Concomitant use contraindicated; if concomitant use is unavoidable, interrupt lomitapide therapy during conivaptan treatment

Crizotinib

Possible increased lomitapide exposure

Concomitant use contraindicated

Cyclosporine

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Dabigatran

Possible increased dabigatran absorption

Consider reducing dabigatran dosage

Digoxin

Possible increased digoxin absorption

Consider reducing digoxin dosage

Everolimus

Possible increased everolimus absorption

Consider reducing everolimus dosage

Ezetimibe

Slight increases in peak plasma concentration and AUC of total ezetimibe

No dosage adjustment of ezetimibe required

Fenofibrate (as micronized formulation)

Decreased peak plasma concentration and AUC of fenofibric acid

No dosage adjustment of fenofibrate required

Fexofenadine

Possible increased fexofenadine absorption

Consider reducing fexofenadine dosage

Ginkgo

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Goldenseal

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Grapefruit juice

Possible increased lomitapide exposure

Avoid concomitant use

Histamine H2-receptor antagonists (cimetidine, ranitidine)

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors (statins) (atorvastatin, lovastatin, rosuvastatin, simvastatin)

Atorvastatin: Increased peak plasma concentration and AUC of atorvastatin acid

Lovastatin: Possible increased lovastatin exposure

Rosuvastatin: Increased peak plasma concentration and AUC of rosuvastatin

Simvastatin: Increased peak plasma concentrations and AUC of simvastatin and simvastatin acid

Atorvastatin: Do not exceed lomitapide dosage of 30 mg daily; no dosage adjustment of atorvastatin required

Lovastatin: Consider reducing lovastatin dosage when lomitapide is initiated

Rosuvastatin: No dosage adjustment of rosuvastatin required

Simvastatin: Reduce simvastatin dosage by 50% when lomitapide is initiated; during concomitant use, do not exceed simvastatin dosage of 20 mg daily (or 40 mg daily in patients who have received the 80-mg daily dosage for ≥1 year without evidence of adverse muscular effects)

Imatinib

Possible increased lomitapide exposure and possible increased imatinib absorption

Concomitant use contraindicated

Isoniazid

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Isotretinoin

Possible increased risk of hepatotoxicity

Use concomitantly with caution; more frequent monitoring of liver function tests may be warranted

Lapatinib

Possible increased lomitapide exposure; possible increased lapatinib absorption

Do not exceed lomitapide dosage of 30 mg daily; consider reducing lapatinib dosage

Macrolides (clarithromycin, erythromycin, telithromycin)

Possible increased lomitapide exposure

Clarithromycin: Substantially increased ALT and AST concentrations

Concomitant use contraindicated; if concomitant use is unavoidable, interrupt lomitapide therapy during anti-infective treatment

Maraviroc

Possible increased maraviroc absorption

Consider reducing maraviroc dosage

Methotrexate

Possible increased risk of hepatotoxicity

Use concomitantly with caution; more frequent monitoring of liver function tests may be warranted

Nefazodone

Possible increased lomitapide exposure

Concomitant use contraindicated

Niacin, extended-release

Increased peak plasma concentrations and AUC of nicotinic acid and nicotinuric acid

No dosage adjustment of extended-release niacin required

Nilotinib

Possible increased lomitapide exposure; possible increased nilotinib absorption

Do not exceed lomitapide dosage of 30 mg daily; consider reducing nilotinib dosage

Oral contraceptives

Possible increased lomitapide exposure

Ethinyl estradiol and norgestimate: Decreased peak plasma concentration and AUC of ethinyl estradiol; increased peak plasma concentration and AUC of 17-deacetyl norgestimate

Do not exceed lomitapide dosage of 30 mg daily; no dosage adjustment of oral contraceptive required

Pazopanib

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Ranolazine

Possible increased lomitapide exposure; possible increased ranolazine absorption

Do not exceed lomitapide dosage of 30 mg daily; consider reducing ranolazine dosage

Sirolimus

Possible increased sirolimus absorption

Consider reducing sirolimus dosage

Tamoxifen

Possible increased risk of hepatotoxicity

Use concomitantly with caution; more frequent monitoring of liver function tests may be warranted

Tetracyclines

Possible increased risk of hepatotoxicity

Use concomitantly with caution; more frequent monitoring of liver function tests may be warranted

Ticagrelor

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Tolvaptan

Possible increased tolvaptan absorption

Consider reducing tolvaptan dosage

Topotecan

Possible increased topotecan absorption

Consider reducing topotecan dosage

Warfarin

Increased plasma concentrations of R- and S-warfarin; increased INR

Monitor INR regularly, particularly following adjustments in lomitapide dosage; adjust warfarin dosage as clinically indicated

Zileuton

Possible increased lomitapide exposure

Do not exceed lomitapide dosage of 30 mg daily

Lomitapide Pharmacokinetics

Absorption

Bioavailability

Absolute bioavailability is approximately 7%.

Peak plasma concentrations attained in about 6 hours following oral administration.

Pharmacokinetics are approximately dose proportional over single-dose range of 10–100 mg.

Special Populations

In patients with mild hepatic impairment (Child-Pugh class A), peak plasma concentration and AUC are increased by 4 and 47%, respectively, compared with individuals with normal hepatic function. (See Hepatic Impairment under Dosage and Administration.)

In patients with moderate hepatic impairment (Child-Pugh class B), peak plasma concentration and AUC are increased by 361 and 164%, respectively, compared with individuals with normal hepatic function. (See Contraindications under Cautions.)

In patients with end-stage renal disease undergoing dialysis, peak plasma concentration and AUC are 50 and 40% higher, respectively, compared with individuals with normal renal function. (See Renal Impairment under Dosage and Administration.)

Distribution

Extent

Not known whether lomitapide distributes into human milk. (See Lactation under Cautions.)

Plasma Protein Binding

99.8%.

Elimination

Metabolism

Metabolized in the liver, principally by CYP3A4; also may be metabolized to a small extent by CYP isoenzymes 1A2, 2B6, 2C8, and 2C19.

Elimination Route

Excreted in urine (53–60%) as metabolites and in feces (33–35%) mainly as unchanged drug.

Half-life

Approximately 40 hours.

Stability

Storage

Oral

Capsules

20–25°C (may be exposed to 15–30°C). Minimize exposure to temperatures up to 40°C. Keep container tightly closed and protect from moisture.

Actions

Advice to Patients

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Distribution of lomitapide is restricted. (See Restricted Distribution Program under Dosage and Administration.)

Lomitapide Mesylate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Capsules

5 mg (of lomitapide)

Juxtapid

Aegerion

10 mg (of lomitapide)

Juxtapid

Aegerion

20 mg (of lomitapide)

Juxtapid

Aegerion

AHFS DI Essentials™. © Copyright 2024, Selected Revisions April 10, 2024. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

Reload page with references included

Frequently asked questions