Support | LIVMARLI® (maralixibat) oral solution and tablets

Two easy ways to prescribe

Fax the enrollment form to 1-855-282-4884.

Access the MAP HCP Portal

Our MAP HCP portal allows you to access everything related to your patients taking Mirum therapies, and includes an option to send prescriptions directly through the portal.

The MAP Portal for HCPs

We've built a portal that provides access to real-time information on your patient's coverage and fulfillment journey. With just a few clicks you can:

Submit prescriptions
Check status of insurance decisions
Manage refills
Provide additional documentation

Track approvals
View patient insurance coverage
Access appeals information

Mirum Access Plus (MAP)

You've chosen LIVMARLI to help your patients. Mirum Access Plus provides the ongoing support they need to start and stay on treatment. We offer comprehensive assistance with insurance and prescription management.

A team dedicated to your patients

Our experienced and dedicated team at Mirum Access Plus will work with your office staff through the access process and assist your patients every step of the way.

Mirum Access Plus Coordinators

Available to your office staff and your patients, Mirum Access Plus Coordinators are experts who specialize in the insurance coverage process and available financial support options.

Financial support for patients

Mirum Access Plus Savings Program: Eligible patients with commercial or private insurance may pay as little as $10 out of pocket per fill for LIVMARLI.*

MAP Mobile for Patients and Caregivers

Mirum Access Plus offers MAP Mobile—a simple online tool that helps your patients navigate updates on their prescription, access helpful medication information, manage refills, and provides them educational resources.

* Eligibility restrictions: This program is not available to individuals who use any state or federal government-funded healthcare program to cover a portion of medication costs, such as Medicare, Medicaid, TRICARE, Department of Defense, or Veterans Administration, or any other state or federal government-funded healthcare program.

MAP resources

"Quite frankly, it was probably the easiest start of a new medication I think I've ever been through."

Mirum Access Plus was there for Téa and her mom every step of the way.

Watch the full video

Not all patients taking LIVMARLI and their caregivers will have the same experience.

"It's been nice to not have to be chasing down doctors for refills and going to the pharmacy to pick things up. It's just so convenient having it right to our door."

Mirum Access Plus helped Tyler start on treatment right away.

Watch the full video

Not all patients taking LIVMARLI and their caregivers will have the same experience.

Reference:

1. LIVMARLI® (maralixibat). Prescribing Information. Mirum Pharmaceuticals, Inc.

Indications

LIVMARLI (maralixibat) oral solution and tablets are indicated for the treatment of cholestatic pruritus in patients who are 3 months of age and older with Alagille syndrome.

LIVMARLI (maralixibat) oral solution and tablets are indicated for the treatment of cholestatic pruritus in patients who are 12 months of age and older with progressive familial intrahepatic cholestasis (PFIC).

Limitations of Use: LIVMARLI is not recommended in a subgroup of PFIC type 2 patients with specific ABCB11 variants resulting in nonfunctional or complete absence of bile salt export pump (BSEP) protein.

Important Safety Information

CONTRAINDICATIONS

LIVMARLI (maralixibat) oral solution and tablets are contraindicated in patients with prior or active hepatic decompensation events (eg, variceal hemorrhage, ascites, or hepatic encephalopathy).

WARNINGS AND PRECAUTIONS

Hepatotoxicity: LIVMARLI treatment is associated with a potential for drug-induced liver injury (DILI). In the PFIC trial, treatment-emergent hepatic decompensation events and elevations of liver tests or worsening of liver tests occurred. Two patients experienced DILI attributable to LIVMARLI. Two additional patients experienced DILI in the open-label extension portion of the trial. Of these 4 patients, 1 patient required liver transplant and another patient died.

In the Alagille syndrome trial, treatment-emergent elevations of liver tests or worsening of liver tests occurred.

Obtain baseline liver tests and monitor during treatment. Liver-related adverse reactions and physical signs of hepatic decompensation should also be monitored. Dose reduction or treatment interruption may be considered if abnormalities occur in the absence of other causes. For persistent or recurrent liver test abnormalities, consider treatment discontinuation. Permanently discontinue LIVMARLI if a patient experiences the following: persistent or recurrent liver test abnormalities, clinical hepatitis, or a hepatic decompensation event.

Gastrointestinal Adverse Reactions: Diarrhea and abdominal pain were reported as the most common adverse reactions. Monitor for dehydration and treat promptly. Consider reducing the dosage or interrupting LIVMARLI treatment if a patient experiences persistent diarrhea or diarrhea with bloody stool, vomiting, dehydration requiring treatment, or fever.

Fat-Soluble Vitamin (FSV) Deficiency: Patients can have FSV deficiency (vitamins A, D, E, and K) at baseline, and LIVMARLI may adversely affect absorption of FSVs. Treatment-emergent bone fracture events have been observed more frequently with patients treated with LIVMARLI compared with patients treated with placebo. If bone fractures or bleeding occurs, consider interrupting LIVMARLI and supplement with FSVs. LIVMARLI can be restarted once FSV deficiency is corrected and maintained at corrected levels.

Risk of Propylene Glycol Toxicity (Pediatric Patients Less Than 5 Years of Age): LIVMARLI oral solution contains propylene glycol. Total daily intake of propylene glycol should be considered for managing the risk of propylene glycol toxicity. Monitor patients for signs of propylene glycol toxicity. Discontinue LIVMARLI if toxicity is suspected.

ADVERSE REACTIONS

Alagille syndrome: The most common adverse reactions are diarrhea, abdominal pain, vomiting, FSV deficiency, liver test abnormalities, and bone fractures.

PFIC: The most common adverse reactions are diarrhea, FSV deficiency, abdominal pain, liver test abnormalities, hematochezia, and bone fractures.

DRUG INTERACTIONS

Administer LIVMARLI at least 4 hours before or 4 hours after administration of bile acid binding resins.

A decrease in the absorption of OATP2B1 substrates (eg, statins) due to OATP2B1 inhibition by LIVMARLI in the GI tract cannot be ruled out. Consider monitoring the drug effects of OATP2B1 substrates as needed.

DOSING INFORMATION

In patients with Alagille syndrome, LIVMARLI is taken once daily, 30 minutes before a meal in the morning. In patients with PFIC, LIVMARLI is taken twice daily, 30 minutes before a meal. Refer to the dosing by weight guidelines in the full Prescribing Information for complete details on dosing for the oral solution and tablet formulations. The provided oral solution dosing dispenser must be used to accurately measure the dose. Any remaining LIVMARLI oral solution should be discarded 100 days after first opening the bottle. LIVMARLI tablets can be used in patients weighing ≥25 kg who can swallow tablets.

Please see full Prescribing Information for LIVMARLI.

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