Straightforward Dosing | CTEXLI™ (chenodiol) | Official HCP Site

CTEXLI (chenodiol) bottle for 250-mg tablets

The first and only FDA-approved treatment for cerebrotendinous xanthomatosis (CTX) in adults comes in a tablet¹

The recommended dosage of CTEXLI is 250 mg orally 3x/day, taken with or without food¹

If a dose is missed, advise patients to skip the missed dose and take the next dose as scheduled. Do not take a double dose¹
Before initiating CTEXLI, obtain baseline liver transaminase (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) and total bilirubin levels in all patients¹
If liver transaminase (ALT, AST) levels are elevated >3x the upper limit of normal (ULN) or total bilirubin level is >2x ULN, interrupt treatment with CTEXLI until the levels have returned to baseline values. Monitor liver transaminase and total bilirubin levels yearly and as clinically indicated¹

Remind patients to stay on CTEXLI

Data show how important it is for patients to stay consistent with their treatment.

Storage and handling

Advise patients to store CTEXLI at room temperature (20 °C to 25 °C [68 °F to 77 °F]) and that excursions are permissible as long as temperatures stay between 15 °C to 30 °C (59 °F to 86 °F).¹

Significant reductions in toxic bile acid precursors

The RESTORE study assessed the impact of CTEXLI on the overproduction of certain toxic bile acid precursors.¹

See CTEXLI Efficacy Data

Getting patients started

From prescription to refill, access support is available for every step of CTEXLI treatment.

Learn about Mirum Access Plus

INDICATION

CTEXLI is indicated for the treatment of cerebrotendinous xanthomatosis (CTX) in adults.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

Hepatotoxicity: Chenodiol, including CTEXLI, has been associated with hepatotoxicity. Patients with preexisting liver disease or bile duct abnormalities may be at a higher risk for hepatotoxicity during treatment.

Before initiating CTEXLI, obtain baseline liver transaminase (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) and total bilirubin levels in all patients. Monitor liver transaminase (ALT, AST) and total bilirubin levels yearly and as clinically indicated. If liver transaminase levels are elevated >3 times the upper limit of normal (ULN) or total bilirubin level is >2 times ULN, interrupt treatment until the levels have returned to baseline values. For persistent or recurrent liver test abnormalities, consider discontinuing CTEXLI.

Inform the patient of the symptoms of hepatotoxicity (e.g., abdominal pain, bruising, dark-colored urine, fatigue, bleeding, jaundice, nausea, and pruritus). Have the patient discontinue CTEXLI immediately if clinical signs and symptoms consistent with hepatotoxicity occur.

ADVERSE REACTIONS

The most common adverse reactions (≥14%) during CTEXLI treatment were diarrhea, headache, abdominal pain, constipation, hypertension, muscular weakness, and upper respiratory tract infection.

DRUG INTERACTIONS

Bile acid sequestering agents and aluminum-based antacids: Avoid concomitant use with CTEXLI. Co-administration of bile acid sequestering agents, such as cholestyramine and colestipol, or aluminum-based antacids may decrease absorption of CTEXLI in the intestine and may result in decreased efficacy.

Coumarin and its derivatives: Monitor prothrombin time and adjust the dosage of coumarin or its derivatives if concomitant use with CTEXLI is unavoidable. Due to potential hepatotoxicity, CTEXLI may affect the pharmacodynamics of coumarin and its derivatives, causing unexpected prolongation of the prothrombin time and hemorrhage.

DOSING AND ADMINISTRATION

The recommended dosage of CTEXLI is 250 mg administered orally three times daily, with or without food. Swallow tablets whole.

Please see accompanying full Prescribing Information.

INDICATION

CTEXLI is indicated for the treatment of cerebrotendinous xanthomatosis (CTX) in adults.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

Hepatotoxicity: Chenodiol, including CTEXLI, has been associated with hepatotoxicity. Patients with preexisting liver disease or bile duct abnormalities may be at a higher risk for hepatotoxicity during treatment.

Before initiating CTEXLI, obtain baseline liver transaminase (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) and total bilirubin levels in all patients. Monitor liver transaminase (ALT, AST) and total bilirubin levels yearly and as clinically indicated. If liver transaminase levels are elevated >3 times the upper limit of normal (ULN) or total bilirubin level is >2 times ULN, interrupt treatment until the levels have returned to baseline values. For persistent or recurrent liver test abnormalities, consider discontinuing CTEXLI.

Inform the patient of the symptoms of hepatotoxicity (e.g., abdominal pain, bruising, dark-colored urine, fatigue, bleeding, jaundice, nausea, and pruritus). Have the patient discontinue CTEXLI immediately if clinical signs and symptoms consistent with hepatotoxicity occur.

ADVERSE REACTIONS

The most common adverse reactions (≥14%) during CTEXLI treatment were diarrhea, headache, abdominal pain, constipation, hypertension, muscular weakness, and upper respiratory tract infection.

DRUG INTERACTIONS

Bile acid sequestering agents and aluminum-based antacids: Avoid concomitant use with CTEXLI. Co-administration of bile acid sequestering agents, such as cholestyramine and colestipol, or aluminum-based antacids may decrease absorption of CTEXLI in the intestine and may result in decreased efficacy.

Coumarin and its derivatives: Monitor prothrombin time and adjust the dosage of coumarin or its derivatives if concomitant use with CTEXLI is unavoidable. Due to potential hepatotoxicity, CTEXLI may affect the pharmacodynamics of coumarin and its derivatives, causing unexpected prolongation of the prothrombin time and hemorrhage.

DOSING AND ADMINISTRATION

The recommended dosage of CTEXLI is 250 mg administered orally three times daily, with or without food. Swallow tablets whole.

Please see accompanying full Prescribing Information.