Maralixibat

Generic name: maralixibat [ MAR-a-LIX-i-bat ]
Brand name: Livmarli
Dosage form: oral solution (19 mg/ml; 9.5 mg/mL)
Drug class: Miscellaneous GI agents

Medically reviewed by Drugs.com on Mar 17, 2025. Written by Cerner Multum.

What is maralixibat?

Maralixibat is used to treat itching due to liver problems in adults and children at least 3 months old with a genetic condition called Alagille syndrome.

Maralixibat is also used to treat itching in certain people with progressive familial intrahepatic cholestasis (a genetic disorder) that causes progressive liver disease in children at least 12 months old.

Maralixibat may also be used for purposes not listed in this medication guide.

Maralixibat side effects

Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Maralixibat may cause serious side effects. Call your doctor at once if you have:

• sudden pain or trouble moving your arm, leg, shoulder, or torso;

• nosebleeds, bleeding gums, abnormal vaginal bleeding, any bleeding that will not stop;

• liver problems--loss of appetite, nausea, vomiting, tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• dehydration--dizziness, confusion, feeling very thirsty, less urination; or

• stomach and intestinal problems--diarrhea, more frequent bowel movements than usual, black, tarry, sticky or bloody stools, or severe stomach pain or tenderness.

Your doctor may change your dose, or your treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects of maralixibat may include:

• stomach pain, vomiting, diarrhea;

• blood in your stools;

• unusual bleeding;

• bone fractures;

• a deficiency in fat-soluble vitamins (vitamin A, D, E, and K); or

• abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Related/similar drugs

Warnings

Use only as directed. Tell your doctor if you use other medicines or have other medical conditions or allergies.

Before taking this medicine

You should not use maralixibat if you are allergic to it, or if you have or have ever had chronic liver problems, such as internal bleeding, fluid buildup in the stomach, or brain-related issues caused by liver disease.

Tell your doctor if you have or have ever had:

• a vitamin A, D, E, or K deficiency; or

• liver disease.

You may be more likely to have a broken bone while using maralixibat. Talk with your doctor about ways to keep your bones healthy.

Maralixibat may contain an ingredient that can cause serious side effects in children younger than 5 years old. Do not give maralixibat to a child without medical advice.

It is not known if maralixibat will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Ask a doctor if it is safe to breastfeed while using this medicine.

How should I take maralixibat?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Maralixibat is given once or twice a day, 30 minutes before a meal. Your doctor will determine your treatment dose and schedule. Follow your doctor's dosing instructions very carefully.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Doses are based on weight. Your dose may change if you gain or lose weight.

Do not change your dose or dosing schedule without your doctor's advice.

You will need frequent blood tests before and during treatment with maralixibat. Your treatment may be delayed, reduced, or permanently discontinued based on the results.

Your doctor may suggest you to take certain vitamin supplements while you are taking maralixibat. Take only the type and amount your doctor has prescribed.

Store at room temperature away from moisture and heat. Throw away any unused medicine 100 days after opening the bottle.

What happens if I miss a dose?

If you take maralixibat once a day: Take the medicine as soon as you can, but skip the missed dose if you are more than 12 hours late for the dose. Do not take two doses at one time.

If you take maralixibat twice a day: Take the medicine as soon as you can, but skip the missed dose if you are more than 6 hours late for the dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking maralixibat?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

What other drugs will affect maralixibat?

Take your maralixibat dose 4 hours before or 4 hours after taking any of the following:

• colesevelam;

• colestipol; or

• cholestyramine.

This list is not complete. Other drugs may affect maralixibat, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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