Evrysdi™ (risdiplam) is indicated for the treatment of spinal muscular atrophy (SMA) in patients 2 months of age and older.
Interactions with Substrates of MATE Transporters
Based on in vitro data, Evrysdi may increase plasma concentrations of drugs eliminated via MATE1 or MATE2-K, such as metformin
Avoid coadministration of Evrysdi with MATE (multidrug and toxin extrusion) substrates. If coadministration cannot be avoided, monitor for drug-related toxicities and consider dosage reduction of the coadministered drug if needed
In animal studies, administration of Evrysdi during pregnancy or throughout pregnancy and lactation resulted in adverse effects on development
Based on animal data, advise pregnant women of the potential risk to the fetus. Pregnancy testing is recommended for females of reproductive potential prior to initiating Evrysdi. Advise female patients of reproductive potential to use effective contraception during treatment with Evrysdi and for at least 1 month after the last dose
There is no data on the presence of Evrysdi in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Evrysdi and any potential adverse effects on the breastfed infant
Potential Effects on Male Fertility
Male fertility may be compromised by treatment with Evrysdi. Counsel male patients on the potential effects on fertility. Male patients may consider sperm preservation prior to treatment
The safety and efficacy of Evrysdi in patients with hepatic impairment have not been studied
Because Evrysdi is predominantly metabolized in the liver, hepatic impairment may potentially increase the exposures to Evrysdi. Avoid use of Evrysdi in patients with impaired hepatic function
Most Common Adverse Reactions
The most common adverse reactions in later-onset SMA (incidence in at least 10% of patients treated with Evrysdi and more frequent than control) were fever, diarrhea, and rash
The most common adverse reactions in infantile-onset SMA were similar to those observed in later-onset SMA patients. Additionally, adverse reactions with an incidence of at least 10% were upper respiratory tract infection, pneumonia, constipation, and vomiting
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