Section 12 · Monograph
Vutrisiran
Reviewed Nov 2026FDA label
AmvuttrasiRNA (TTR-directed)
- Forms
- SC: 25mg/0.5mL prefilled syringe
- Dose
- 25mg SC every 3 months (given by healthcare professional); vitamin A supplementation advised
- MOA
- Silences hepatic transthyretin (TTR) synthesis
Indications
- Polyneuropathy of hereditary transthyretin-mediated (hATTR) amyloidosis in adultsFDA-labeled
- Cardiomyopathy of wild-type or hereditary transthyretin-mediated amyloidosis in adults (added March 2025)FDA-labeled
Mechanism of Action
- Transthyretin-directed small interfering RNA (siRNA) delivered to hepatocytes; degrades TTR mRNA, reducing serum TTR protein
Full Dosing
Adult / usual
- 25mg by subcutaneous injection once every 3 months, administered by a healthcare professional
- Supplement with vitamin A at the recommended daily allowance (not above) unless contraindicated
- Missed dose: give as soon as possible and resume every 3 months from the most recently administered dose
Contraindications
- None listed in labeling
Drug Interactions
- No clinical drug-interaction studies; interactions not expected
Adverse Effects
- Arthralgia, dyspnea, injection-site reactions
- Reduced serum vitamin A levels with possible ocular symptoms (night blindness, dry eyes)
Monitoring Parameters
- Ocular symptoms of vitamin A deficiency (refer to ophthalmology)
- Neuropathy scales and neurologic function
- Cardiac function in patients with cardiomyopathy
Pregnancy & Lactation
- Reduced vitamin A may harm the fetus; avoid in pregnancy unless benefit justifies risk; animal developmental toxicity at maternally toxic doses
- No information on presence in human milk