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Dosing, Titration, and Monitoring

Flexibility to rapidly titrate as early as 2 weeks and reach maintenance dose within 8 weeks1

INDIVIDUALIZED DOSING

Dosing is individualized based on the patient’s LVEF and LVOT gradient1

  • Recommended starting dose: 5 mg once daily
  • Echocardiogram performed 2 to 8 weeks after initiation of treatment or dose adjustment due to LVEF and LVOT gradient or drug interaction
    • After a treatment interruption due to low LVEF, resume treatment, no earlier than 7 days, when LVEF ≥55% and re-initiate dose titration at the starting dose of 5 mg
  • Increase dose every 2 to 8 weeks by 5 mg until 20 mg once daily or maintenance dose is achieved
  • Maintenance monitoring: Echocardiogram every 6 months for patients with LVEF ≥55%
    • Every 3 months if LVEF is <55% and ≥50%
  • MYQORZO should be taken once daily with or without meals at about the same time every day. Swallow tablets whole
    • If a dose is missed, it should be taken as soon as possible on the same day. The next scheduled dose should be taken at the usual time the following day. Two doses of MYQORZO should not be taken on the same day
MYQORZO™ titration and dose adjustment
LVEFValsalva LVOT gradientDose adjustment
≥55%≥30 mmHgIncrease dose by 5 mg (up to the maximum dose of 20 mg once daily)
≥55%<30 mmHgMaintain dose
<55% and ≥50%AnyMaintain dose
<50% and ≥40%Any

Decrease dose by 5 mg*

If already on 5 mg, interrupt treatment for at least 7 days

<40%AnyInterrupt treatment for at least 7 days

Consider enhanced monitoring for patients with intercurrent illness (eg, severe infection or COVID-19), new arrhythmia, or any other condition that may impair systolic function.†

*Decrease dose as follows: 20 mg to 15 mg, 15 mg to 10 mg, and 10 mg to 5 mg.1

†Do not increase dose until intercurrent illness or new arrhythmia has resolved or stabilized.1

MYQORZO is available in

4 dosage strengths1:

The 4 dosage strengths: 5 mg, 10 mg, 15 mg, and 20 mg

MYQORZO is only available through the MYQORZO Risk Evaluation and Mitigation Strategy (REMS) Program to mitigate the risk of heart failure due to systolic dysfunction.

Know the steps for determining the individualized dose of MYQORZO for your patients1

  1. Perform a baseline echocardiogram and initiate with the recommended starting dose (5 mg).
  2. Conduct an echocardiogram 2 to 8 weeks after initiation of treatment or dose adjustment due to LVEF and LVOT gradient or drug interaction. After a treatment interruption due to low LVEF, resume treatment, no earlier than 7 days, when LVEF ≥55% and re-initiate dose titration at the starting dose of 5 mg.
  3. Based on the echocardiogram results, enter your patient's LVEF and Valsalva LVOT gradient in the calculator to find out the dose adjustment that is needed.

Interactive Dosing & Titration Tool

Support your treatment plan with the Dosing & Titration Tool

Is your patient taking MYQORZO?

  • Initiation or up-titration in patients with LVEF <55% is not recommended1
  • Consider monitoring LVEF and adjust the dose, as needed, in patients with an intercurrent illness, new arrhythmia, or any other conditions that may impair systolic function. Do not increase the dose until the intercurrent illness or new arrhythmia has resolved or stabilized1
  • Please review the dosing modifications for patients receiving inhibitors of multiple CYPs, strong CYP2C9 inhibitors, and moderate-to-strong CYP3A inducers

DOSING MODIFICATIONS

Dosing recommendations with specific drug-drug interactions1

  • Concomitant use with rifampin is contraindicated
  • For patients taking stable doses of concomitant drugs or discontinuing a moderate-to-strong CYP3A inducer, initiate MYQORZO at the recommended starting dose of 5 mg once daily

Dose adjustments for patients taking stable doses of MYQORZO

Concomitant drugMYQORZO dose
Inhibitors of multiple CYPs or strong CYP2C9 inhibitors
Patients intending to initiate fluvoxamine or a strong CYP2C9 inhibitor

Reduce dose from 20 mg to 10 mg, 15 mg to 5 mg, 10 mg to 5 mg

Maintain 5 mg dose if currently receiving 5 mg

Patients intending to initiate fluconazole (>3 days) or voriconazole

If currently receiving 15 mg or 20 mg, reduce dose to 5 mg

If currently receiving 5 mg or 10 mg, avoid concomitant use

Moderate-to-strong CYP3A inducers
Patients intending to discontinue a moderate-to-strong CYP3A inducer

Reduce dose from 20 mg to 10 mg, 15 mg to 5 mg, 10 mg to 5 mg

Maintain 5 mg dose if currently receiving 5 mg

Assess LVEF and LVOT gradient 2 to 8 weeks following initiation or discontinuation of the above concomitant medications and titrate dose of MYQORZO accordingly.

Review clinical trial results for MYQORZO

Discover the data

Explore safety data for MYQORZO

View the safety profile

COVID-19=coronavirus disease 2019; CYP=cytochrome; LVEF=left ventricular ejection fraction; LVOT=left ventricular outflow tract.

Reference: 1. MYQORZO (aficamten). Prescribing information. Cytokinetics; 2025.

IMPORTANT SAFETY INFORMATION

WARNING: RISK OF HEART FAILURE

MYQORZO reduces left ventricular ejection fraction (LVEF) and can cause heart failure due to systolic dysfunction.

Echocardiogram assessments are required prior to and during treatment with MYQORZO to monitor for systolic dysfunction. Initiation of MYQORZO in patients with LVEF <55% is not recommended. Decrease the dose of MYQORZO if LVEF is <50% and ≥40%. Interrupt the dose of MYQORZO if LVEF <40% or if the patient experiences heart failure symptoms or worsening clinical status due to systolic dysfunction.

Because of the risk of heart failure due to systolic dysfunction, MYQORZO is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the MYQORZO REMS Program.

CONTRAINDICATIONS

MYQORZO is contraindicated with concomitant use of rifampin.

WARNING AND PRECAUTIONS

Heart Failure
MYQORZO reduces cardiac contractility, which can reduce LVEF and cause heart failure.

Patients who experience a serious intercurrent illness (eg, serious infection) or arrhythmia (eg, new or uncontrolled atrial fibrillation) may be at greater risk of developing systolic dysfunction and heart failure.

Assess patients’ clinical status and LVEF prior to and during treatment and adjust the MYQORZO dose accordingly. New or worsening arrhythmia, dyspnea, chest pain, fatigue, leg edema, or elevations in N-terminal pro-B-type natriuretic peptide may be signs and symptoms of heart failure.

Initiation of MYQORZO in patients with LVEF <55% is not recommended.

MYQORZO REMS Program

MYQORZO is available only through a restricted program called the MYQORZO REMS Program, because of the risk of heart failure due to systolic dysfunction.

Notable requirements of the MYQORZO REMS Program include:

  • Prescribers must be certified by enrolling in the MYQORZO REMS Program
  • Patients must enroll in the MYQORZO REMS Program and comply with ongoing monitoring requirements
  • Pharmacies must be certified by enrolling in the MYQORZO REMS Program and must only dispense to patients who are authorized to receive MYQORZO
  • Wholesalers and distributors must only distribute to certified pharmacies

Further information is available at www.MYQORZOREMS.com, or at 1-844-285-7367.

Cytochrome P450 Interactions Leading to Heart Failure or Loss of Effectiveness
MYQORZO is metabolized primarily by CYP2C9, and to a lesser extent by CYP3A, CYP2D6, and CYP2C19 enzymes. Initiation of medications that inhibit multiple P450 pathways of MYQORZO elimination (eg, fluconazole, voriconazole, or fluvoxamine) or strong CYP2C9 inhibitors, and discontinuation of moderate-to-strong CYP3A inducers may lead to increased blood concentrations of aficamten and increase the risk of heart failure due to systolic dysfunction. Conversely, initiation of medications that induce P450 pathways of MYQORZO (eg, rifampin, moderate-to-strong CYP3A inducers) may lead to decreased blood concentrations of aficamten and potential loss of effectiveness. Assess LVEF 2 to 8 weeks after initiation of such inhibitors or after discontinuation of such inducers and adjust the dose of MYQORZO accordingly.

Advise patients of the potential for drug interactions. Advise patients to inform their healthcare provider of all concomitant medications prior to and during MYQORZO treatment.

ADVERSE REACTIONS

Hypertension (8% vs 2%) was the only adverse reaction occurring in >5% of patients and more commonly on MYQORZO than on placebo in the pivotal trial.

INDICATIONS AND USAGE

MYQORZO is indicated for the treatment of adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) to improve functional capacity and symptoms.

Please see full Prescribing Information, including Boxed WARNING.