Hypertrophic Cardiomyopathy Drug Summary

Last updated: 14 June 2024
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Beta-blocker

Drug Dosage Remarks
Propranolol 10-40 mg PO 6-8 hourly
Max dose: 160 mg/day		 Adverse Reactions
  • CNS effects (fatigue, sleep disturbances, nightmares); CV effects (slow or irregular heartbeat, coldness of extremities, Raynaud’s syndrome); Respiratory effects (bronchospasm in susceptible patients and drugs with beta1 selectivity should be used with caution); GI effect (GI disturbance)
Special Instructions
  • Contraindicated in uncontrolled heart failure, shock, heart conduction or rhythm problems, bradycardia, low BP, severe blood circulation problems, DM, metabolic acidosis, prolonged fasting, Prinzmetal’s angina, untreated pheochromocytoma, history of bronchospasm
  • Use with caution in patients with history of allergic reactions, 1st-degree heart block, poor cardiac reserve, blood circulation problems, hyperthyroidism, renal or hepatic impairment, concomitant use with anesthesia and patients on Insulin
  • Beta-blockers may mask the symptoms of hyperthyroidism and hypoglycemia and may aggravate psoriasis
  • Patients on long-term treatment should not discontinue abruptly; should discontinue gradually over 1-2 weeks

Other Cardiovascular Drug

Drug Dosage Remarks
Mavacamten Initiation phase:
5 mg PO 24 hourly initially
Adjust dose every 4 weeks based on response

Maintenance phase:
2.5-15 mg PO 24 hourly
Adjust dose every 12 weeks based on response		 Adverse Reactions
  • CNS effect (dizziness); CV effects (decreased LVEF, syncope)
  • Can cause heart failure due to systolic dysfunction
Special Instructions
  • Assess LVEF, Valsalva LVOT gradient and patient’s clinical status when initiating or titrating the dose
    • Do not initiate treatment in patients with LVEF <55%
    • Interrupt treatment at any time if LVEF <50% or if patient’s clinical status worsens
  • Use with caution in patients with arrhythmia
  • Contraindicated in pregnancy
  • Avoid concomitant use with Disopyramide in combination with Verapamil or Diltiazem
    • If a negative inotrope is started or if the dose of a negative inotrope is increased while on Mavacamten, LVEF should be closely monitored until stable dosages and clinical response have been reached
  • Avoid concomitant use of strong CYP2C19 and CYP3A4 inhibitors or inducers

Disclaimer

All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.  
Not all products are available or approved for above use in all countries.  
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.   
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.  

Related MIMS Drugs