avacopan at a glance
Medicine class
Selective complement C5a receptor inhibitor
Licensed role
Combination treatment for adults with severe, active GPA or MPA
Administration
Take with food and swallow capsules whole with water
Monitoring
Liver function, blood counts and signs of serious infection require monitoring
What is avacopan used for?
Avacopan is licensed as part of combination treatment for adults with severe, active ANCA-associated vasculitis.
Severe, active granulomatosis with polyangiitis (GPA)
Severe, active microscopic polyangiitis (MPA)
Its licence requires use with a rituximab- or cyclophosphamide-based regimen.
How does avacopan work?
Avacopan blocks the C5a receptor, a complement-system signal that activates and attracts neutrophils to inflamed blood vessels. This reduces complement-driven inflammation without blocking formation of the terminal complement complex.
avacopan preparations and strengths
Capsule
Route: Oral
Strengths: 10 mg
How to take avacopan
Follow the specialist team's instructions.
Take the capsules with food.
Swallow them whole with water; do not crush, chew or open them.
Avoid grapefruit and grapefruit juice.
avacopan side effects
Common or expected effects
- Nausea or vomiting
- Diarrhoea
- Headache
- Upper respiratory or nose and throat infections
- Reduced white blood cell count
- Abnormal liver blood tests
Get urgent medical advice
- Liver injury, including jaundice or severe itching
- Pneumonia or another serious infection
- Angioedema causing facial, mouth or throat swelling
- Markedly reduced white blood cells, sometimes presenting with infection, bruising or bleeding
avacopan in pregnancy
Human pregnancy data are inadequate, and animal studies found reproductive toxicity. Avacopan is not recommended during pregnancy or for someone who could become pregnant and is not using contraception. Seek prompt specialist review if pregnancy is planned or suspected.
avacopan while breastfeeding
It is unknown whether avacopan passes into human milk, and a risk to a breastfed child cannot be excluded. A specialist should weigh the benefits of breastfeeding against the benefits of treatment.
avacopan interactions
Avacopan is metabolised mainly through CYP3A4 and can increase exposure to some other medicines. The full medicines and supplement list should be reviewed whenever it changes.
Strong CYP3A4 inducers, including rifampicin, carbamazepine, phenytoin, phenobarbital and St John's wort
These can substantially reduce avacopan exposure and should generally be avoided because disease control may be lost.
Strong CYP3A4 inhibitors, including clarithromycin and azole antifungals
These can increase avacopan exposure, so adverse-effect monitoring may be needed.
Grapefruit and grapefruit juice
These may increase avacopan concentrations and should be avoided.
Common questions about avacopan
Answers are fully visible for fast scanning and source review.
What conditions is avacopan used to treat?
It is licensed for adults with severe, active GPA or MPA, two forms of ANCA-associated small-vessel vasculitis.
Is avacopan used on its own?
No. Its licence requires use with a rituximab- or cyclophosphamide-based regimen under specialist care.
Why must avacopan be taken with food?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.