Three-Dimensional Geometry and Flow Dynamics Define Distinct Mechanisms of Mitral Stenosis
January 26, 2026
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Brand Name :
Myqorzo
Synonyms :
aficamten
Class :
Cardiac Myosin Inhibitors
Brand Name :
Myqorzo
Synonyms :
aficamten
Class :
Cardiac Myosin Inhibitors
Dosage forms and strengths
Oral tablet
20 mg
15 mg
10 mg
5 mg
Cardiomyopathy
Administer 5 mg orally one time in a day
The dose may be increased by 5 mg every 2 to 8 weeks until the maintenance dose or the maximum recommended dose of 20 mg a day is reached
Pediatric dosing
Safety and efficacy are not established
Action and spectrum:
Actions:
Aficamten is a selective cardiac myosin inhibitor that works by directly targeting the cardiac sarcomere, the contractile machinery of heart muscle cells. It reduces the number of myosin-actin cross-bridges formed during contraction, which decreases excessive cardiac contractility without affecting relaxation. By lowering hypercontractility, aficamten helps reduce obstruction in the left ventricular outflow tract (LVOT) in hypertrophic cardiomyopathy and alleviates associated symptoms such as shortness of breath, chest pain, and fatigue.
Frequency Defined
1-10%
Hypertension 8%
Black Box Warning
Aficamten can lower left ventricular ejection fraction (LVEF) and may lead to heart failure due to impaired systolic function. Regular echocardiographic evaluations are recommended before starting treatment and periodically during therapy to monitor cardiac function.
Contraindication/Caution
Contraindications
Coadministration with rifampin
Caution
Interactions with CYP450 enzymes may affect aficamten levels
Heart failure
Pregnancy / Lactation
Pregnancy Warnings:
Pregnancy category: N/A
Lactation: Excretion in human breastmilk is unknown
Pregnancy categories:
Category A: Satisfactory and well-controlled studies show no evidence of risk to the fetus in the first trimester or in the later trimester.
Category B: No evidence of risk to fetus found in animal reproduction studies and there are not enough studies on pregnant women.
Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women.
Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits.
Category X: Drugs listed in this category clearly outweigh risks over benefits. These category drugs should be prohibited for pregnant women.
Category N: There is no data available for the drug under this category.
Pharmacology
Aficamten is a selective cardiac myosin inhibitor that modulates the contractile function of the heart. By reducing the number of myosin-actin cross-bridges, it decreases excessive cardiac contractility without impairing relaxation. This mechanism helps reduce left ventricular outflow tract (LVOT) obstruction in hypertrophic cardiomyopathy, improving symptoms such as shortness of breath, chest pain, and fatigue.
Pharmacokinetics:
Absorption
After oral administration, aficamten is quickly absorbed, reaching its peak concentration in the blood (Tmax) within about 1.5 to 2 hours.
Distribution
It is widely distributed in the body.
Metabolism
The primary metabolites found in the plasma are the hydroxylated compounds CK-3834282 and CK-3834283, which do not exhibit pharmacological activity at therapeutic levels.
Excretion and Elimination
Aficamten is mainly cleared from the body through metabolism, with approximately 85% of the administered dose excreted in urine and 44.1% in feces, primarily as its main metabolite.
Administration
Take the tablet once daily, with or without food, at approximately the same time each day. Swallow the tablet whole without crushing or splitting. If a dose is missed, take it as soon as possible on the same day. Then, resume your next dose at the regular scheduled time the following day.
Patient information leaflet
Generic Name: aficamten
Why do we use aficamten?
Aficamten is primarily used in obstructive hypertrophic cardiomyopathy (oHCM), where it lowers left ventricular outflow tract (LVOT) obstruction and reduces excessive cardiac contractility, helping to alleviate symptoms such as shortness of breath, chest pain, and fatigue in adults with NYHA class II–III symptoms.
It is also being studied in non-obstructive hypertrophic cardiomyopathy (nHCM) to decrease hypercontractility and improve cardiac function in patients without LVOT obstruction.
Additionally, early research suggests that aficamten may have potential applications in certain types of heart failure by reducing myocardial hypercontractility, although this use is still experimental.
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