Seladelpar
Pronunciation: sell-a-dell-pah
Generic name: seladelpar
Brand name: Livdelzi
Dosage form: oral capsule (10 mg)
Drug class: Miscellaneous metabolic agents
What is seladelpar?
Seladelpar is used to treat primary biliary cholangitis (PBC) in adults in combination with ursodeoxycholic acid (UDCA) in adults who have not responded well to UDCA, or used alone in patients unable to tolerate UDCA. It is an oral capsule taken once a day.
- Seladelpar is not for use in people who have advanced liver disease (decompensated cirrhosis).
Seladelpar works by activating specific receptors that control key metabolic and liver disease pathways involved in bile acid synthesis, inflammation, and fibrosis, as well as lipid metabolism, storage, and transport. This reduces bile acid production and helps counteract liver damage caused by bile acid buildup in PBC patients. It is unknown if it improves survival or prevents liver decompensation. Seladelpar belongs to the drug class called peroxisome proliferator-activated receptor (PPAR)-delta agonists.
Seladelpar gained FDA approval on August 14, 2024, under the brand name Livdelzi, manufactured by Gilead Sciences Inc. There is no generic Livdelzi.
- This approval is under the accelerated approval designation. Continued approval may be contingent on a continued benefit being shown in clinical trials.
- Approval was based on results of the Phase 3 RESPONSE trial (NCT04620733), where 62% of participants achieved composite biochemical response versus 20% on placebo. Additionally, 25% normalized ALP levels (versus 0% placebo), and patients experienced statistically significant pruritus reduction compared to placebo.
Side effects
The most common side effects of seladelpar are:
- headache
- stomach (abdominal) pain
- nausea
- abdominal swelling (distension)
- dizziness.
Serious side effects and warnings
Seladelpar can cause the following serious side effects:
- Bone fractures. Taking seladelpar may increase your risk of bone fractures. Tell your healthcare provider about any bone fractures, if you develop pain, or have changes in your ability to move around.
- Changes in liver tests. Increased liver enzymes in the blood have occurred when taking more seladelpar than prescribed. Your healthcare provider will do tests to check your liver before you start and during treatment with seladelpar. Tell your healthcare provider right away if you have any of the following signs or symptoms of worsening liver problems during treatment with seladelpar:
- swelling of your stomach area (abdomen) from a build-up of fluid
- yellowing of your skin or the whites of your eyes
- mental changes such as confusion, being sleepier than usual, or harder to wake up,
- pain on the right side of your stomach, slurred speech, mood swings, or changes (abdomen) in personality
- black, tarry, or bloody stools
- coughing up or vomiting blood, or your vomit looks like “coffee grounds”.
It is not known if seladelpar is safe and effective in children.
Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all the possible side effects of seladelpar. 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
Seladelpar should not be used in those with advanced liver disease (decompensated cirrhosis). Symptoms of advanced liver disease may include:
- confusion
- fluid in the stomach area (abdomen)
- black, tarry, or bloody stools
- coughing up or vomiting blood
- vomit that looks like “coffee grounds”.
Before taking seladelpar, tell your healthcare provider about all your medical conditions, including if you:
- have liver disease.
- think you may have a blockage of the bile ducts in your liver (biliary obstruction)
- are pregnant or plan to become pregnant
- are breastfeeding or plan to breastfeed
Pregnancy
It is not known if seladelpar will harm an unborn baby. If you become pregnant while taking seladelpar, tell your healthcare provider right away.
There is a pregnancy safety study for women who take seladelpar during pregnancy. Talk to your healthcare provider about providing information about the Livdelzi (seladelpar) pregnancy safety study. The purpose of this pregnancy safety study is to capture information about your health and your baby’s health. You or your healthcare provider can report your pregnancy by calling 1-800-445-3235.
Breastfeeding
It is not known if seladelpar passes into your breast milk. Talk with your healthcare provider about the best way to feed your baby if you take seladelpar.
How should I take seladelpar?
Take seladelpar exactly as your healthcare provider tells you to. Do not take more seladelpar than your healthcare provider tells you to.
- Take seladelpar once a day.
- May be taken with or without food.
- If you also take medicines to help lower your cholesterol (bile acid-binding resins), take seladelpar at least 4 hours before or 4 hours after you take the bile acid-binding resin. If this is not possible, space the time between taking seladelpar and your bile acid-binding resin as far apart as possible.
Dosing information
Dose of seladelpar for PBC (Adult)
- 10 mg (1 capsule) once a day.
- Take with or without food.
What happens if I overdose
If you take too much seladelpar, call your healthcare provider or get emergency medical help right away.
What other drugs will affect seladelpar?
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Seladelpar can affect the way certain medicines work. Certain other medicines may affect the way this medicine works. Especially tell your healthcare provider if you take:
- OAT3 inhibitors, such as probenecid, rifampin, or cabotegravir. Avoid taking together or monitor ALP and bilirubin for rifampin
- Strong CYP2C9 inhibitors, such as cotrimoxazole, fluoxetine, or amiodarone. Avoid taking together
- Dual moderate CYP2C9 and moderate to strong CYP3A4 inhibitors, such as fluconazole. Monitor closely for side effects
- CYP2C9 poor metabolizers using moderate to strong CYP3A4 inhibitors: Monitor more frequently for side effects.
- BCRP inhibitors such as rosuvastatin, glyburide, nitrofurantoin, dipyridamole, cimetidine, chlorothiazide, sulfasalazine, and leflunomide. Monitor closely for adverse effects.
Seladelpar should be taken at least 4 hours before or 4 hours after you take medicines to help lower your cholesterol, called bile acid-binding resins (examples include cholestyramine or colestipol). If this is not possible, space the time between taking seladelpar and your bile acid-binding resin as far apart as possible.
This is not a complete list of interactions. See the Livdelzi (seladelpar) Package Insert for a full list.
Storage
Store capsules at room temperature between 68°F to 77°F (20°C to 25°C).
Keep out of the reach of children.
Ingredients
Seladelpar is only available under the brand name Livdelzi. There is no generic.
Active ingredient: seladelpar lysine
Inactive ingredients (Livdelzi): butylated hydroxytoluene, colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, mannitol, microcrystalline cellulose, and hard gelatin shells.
Capsule shells contain gelatin, titanium dioxide, black iron oxide, yellow iron oxide, red iron oxide, and the colorant FD&C Blue #2.
Seladelpar is available as a 10 mg capsule.
Manufacturer
Seladelpar is manufactured by Gilead Sciences, Inc., under the brand Livdelzi. Gilead Sciences' headquarters are in Foster City, California.
References
More about seladelpar
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- Drug class: miscellaneous metabolic agents
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