How Mavacamten (Camzyos) Treats Obstructive Hypertrophic Cardiomyopathy (HCM)

If your current medications aren’t doing enough to manage your obstructive hypertrophic cardiomyopathy (HCM), your cardiologist may recommend mavacamten (Camzyos). The drug helps your heart relax, reducing symptoms such as fatigue and shortness of breath.

Mavacamten works differently from other medications for this genetic condition. Talk to your doctor about whether it can make a difference for your HCM symptoms.

“It lowers heart muscle contraction at the molecular level, allowing the heart to pump more efficiently and relax more effectively, which can relieve obstruction and improve symptoms,” says Mohammed Makkiya, MD, the director of the HCM clinic at VCU Health Pauley Heart Center in Richmond, Virginia.

“These are often patients who are experiencing shortness of breath, chest pain, or exercise intolerance but who are not yet ready for or who may want to avoid an invasive procedure,” like surgery, Dr. Makkiya says.

“Patient will say things like, ‘I used to have to stop at the top of a flight of stairs because of shortness of breath, but now I can walk three flights of stairs without stopping,’ or ‘I get less chest pressure or palpitations when walking around,’” says Sandeep Jani, MD, MPH, the medical director of advanced heart failure for the Baltimore region for MedStar Health.

“Because mavacamten decreases heart muscle contraction, there is a possibility that the heart muscle may overreact to it, increasing the risk of the heart becoming too weak,” Makkiya says.

Mavacamten is only available as part of a risk evaluation and mitigation strategy (REMS) program, which requires ongoing monitoring to ensure you aren’t developing heart failure. This makes getting a prescription more complex, as it requires you and your cardiologist to be enrolled in the REMS program.

• Evaluate your heart failure risk with an echocardiogram 
• Assess your existing medications to rule out interactions with mavacamten. Taking diltiazem, disopyramide (Norpace), ranolazine, rifampin, or verapamil with a beta-blocker can increase your risk of heart failure or heart-rhythm problems, for example.

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• Check your heart function with echocardiograms regularly. These are required to continue or increase mavacamten dosages.

“When prescribed appropriately within [REMS], mavacamten is very safe, and dose adjustments can prevent long-term problems,” Makkiya says.

• Dizziness (most common)
• Fainting (most common)
• Breathing issues
• Chest pain or tightness
• Dilation of neck veins
• Fatigue and weakness
• Irregular heartbeat
• Reduced urine volume
• Swelling in your fingers, face, feet, or lower legs
• Weight gain

Mavacamten isn’t for people who are pregnant or taking certain medications, so it’s important to discuss your risk factors with your cardiologist. Do not smoke or consume alcohol while taking mavacamten, as interactions may occur.

• The medication mavacamten (Camzyos) can improve or eliminate symptoms of the heart condition obstructive hypertrophic cardiomyopathy (HCM), such as shortness of breath or chest pain, but the FDA has not approved the drug for non-obstructive HCM.
• Mavacamten reduces the protein interaction that makes your heart contract with too much force, helping it work more efficiently.
• Because taking mavacamten could increase the risk of heart failure, qualifying for a prescription requires regimented, regular checkups and an assessment of potential medication interactions.
• Dizziness and fainting are mavacamten’s most common side effects.