Daily Medication Pearl: Maralixibat (Livmarli) for Cholestatic Pruritus

Maralixibat decreases the reabsorption of bile acids from the terminal ileum for the treatment of cholestatic pruritus in patients with Alagille syndrome.

Clinical Pearl of the Day: Maralixibat (Livmarli)

Maralixibat is an ileal bile acid transporter inhibitor indicated for the treatment of cholestatic pruritus in patients with Alagille syndrome 1 year of age and older.

Insight:

  • Dosage: The recommended dosage is 380 mcg/kg once daily, taken 30 minutes before the first meal of the day. Starting dose is 190 mcg/kg orally once daily and should be increased to 380 mcg/kg once daily after 1 week, as tolerated.
  • Dosing: Oral solution 9.5 mg of maralixibat per mL.
  • Adverse events: Include diarrhea, abdominal pain, vomiting, fat-soluble vitamin deficiency, liver test abnormalities, gastrointestinal bleeding, and bone fractures.
  • Mechanism of action: Maralixibat decreases the reabsorption of bile acids (primarily the salt forms) from the terminal ileum.
  • Manufacturer: Mirum

Sources:

Approval [Rx ONLY] (mirumpharma.com)

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