Dr. Albert Friesen reports

MEDICURE REITERATES ITS COMMITMENT TO PROVIDING EXCEPTIONAL ACCESS TO ITS BRANDED PITAVASTATIN (ZYPITAMAG) TO PEOPLE LIVING WITH HIV

Medicure Inc. has reaffirmed its commitment to providing affordable and straightforward access to its branded pitavastatin, Zypitamag, to people living with HIV through two important channels: its pharmacy subsidiary Marley Drug and through the AIDS Drug Assistance Program (ADAP) Crisis Task Force formulary. Access to branded medications can be challenging, however Medicure recognizes that access to pitavastatin is more important than ever in light of the recently published REPREIVE study (randomized trial to prevent vascular events in HIV), which reported the benefits of pitavastatin for people living with HIV who are at increased risk of developing heart and vascular diseases. The effect of Zypitamag on cardiovascular morbidity and mortality has not been determined.

The progressive advancements in antiretroviral therapy have significantly enhanced the life expectancy in individuals with HIV, leading to a surge in age- and therapy-related co-morbidities. It is now recognized that people living with HIV have an escalated risk of heart and vascular diseases, and the treatment of primary hyperlipidemia or mixed dyslipidemia with pitavastatin may be beneficial.

Unlike most statins, pitavastatin (Zypitamag) is minimally metabolized by the CYP450 family of enzymes, reducing the likelihood of certain drug-drug interactions. This makes pitavastatin particularly suitable for patients taking multiple medications, such as those living with HIV2-5.

"I am pleased to emphasize Medicure's steadfast commitment to making Zypitamag both accessible and affordable for those who may benefit from it, especially persons living with HIV. Our collaboration with the ADAP Crisis Task Force over the past years further reflects our dedication to affordability and accessibility, ensuring that this vital medication is within reach of those who need it. Also through our subsidiary Marley Drug, we can offer Zypitamag at an affordable cash price to all Americans, without the need for insurance, prior authorizations or step through therapy," said Dr. Albert Friesen, chief executive officer for Medicure.

The ADAP Crisis Task Force continues to negotiate drug prices for all ADAP formularies, providing essential HIV treatment to low-income, uninsured and underinsured individuals across the United States. Medicure's engagement with the task force amplifies its mission to offer effective and reasonably priced statin therapy to those who may benefit significantly.

Please refer to important safety information herein and the full prescribing information for Zypitamag (pitavastatin) tablets.

Important safety information for Zypitamag (pitavastatin) tablets

Indications and usage

Zypitamag is indicated as an adjunctive therapy to diet in adult patients with primary hyperlipidemia or mixed dyslipidemia to reduce elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), triglycerides (TG) and to increase high-density lipoprotein cholesterol (HDL-C). Limitations of use: The effect of Zypitamag on cardiovascular morbidity and mortality has not been determined.

Contraindications: Zypitamag is contraindicated in patients with a known hypersensitivity to product components, in patients with active liver disease (which may include unexplained persistent elevations in hepatic transaminase levels), in women who are pregnant or may become pregnant, in nursing mothers, or in co-administration with cyclosporine.

Warnings and precautions

• Myopathy and rhabdomyolysis: Risk factors include age 65 and greater, renal impairment, inadequately treated hypothyroidism, concomitant use of certain drugs, and higher doses of Zypitamag. Zypitamag is contraindicated in patients taking cyclosporine and not recommended in patients taking gemfibrozil. The following drugs when used concomitantly with Zypitamag may also increase the risk of myopathy and rhabdomyolysis: lipid-modifying dosages of niacin (greater than one gram/day), fibrates and colchicine. Discontinue Zypitamag if markedly elevated CK levels occur or myopathy is diagnosed or suspected. Temporarily discontinue Zypitamag in patients experiencing an acute or serious condition at high risk of developing renal failure secondary to rhabdomyolysis; for example, sepsis; shock; severe hypovolemia; major surgery; trauma; severe metabolic, endocrine or electrolyte disorders; or uncontrolled epilepsy. Inform patients of the risk of myopathy and rhabdomyolysis when starting or increasing the Zypitamag dosage. Instruct patients to promptly report any unexplained muscle pain, tenderness or weakness particularly if accompanied by malaise or fever.
• Immune-mediated necrotizing myopathy (IMNM): There have been rare reports of IMNM, an autoimmune myopathy, associated with statin use. IMNM is characterized by: proximal muscle weakness and elevated serum creatine kinase, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents.
• Hepatic dysfunction: Increases in serum transaminases can occur. Rare postmarketing reports of fatal and non-fatal hepatic failure have occurred. Consider liver enzyme testing before initiating therapy and as clinically indicated thereafter. If serious hepatic injury with clinical symptoms and/or hyperbilirubinemia or jaundice occurs, promptly discontinue Zypitamag.
• Increases in HbA1c and fasting serum glucose levels: Increases of each have been reported with statins, including Zypitamag. Optimize lifestyle measures, including regular exercise, maintaining a healthy body weight and making healthy food choices.

Adverse reactions: The most frequent adverse reactions (rate greater than or equal to 2 per cent) are myalgia, back pain, diarrhea, constipation and pain in extremity. This is not a complete list of all reported adverse events.

About Medicure Inc.

Medicure is a pharmaceutical company focused on the development and commercialization of therapies for the U.S. cardiovascular market. The present focus of the company is the marketing and distribution of Aggrastat (tirofiban hydrochloride) injection and Zypitamag (pitavastatin) tablets in the United States, where they are sold through the company's U.S. subsidiary, Medicure Pharma Inc. Medicure also operates Marley Drug, a pharmacy located in North Carolina that offers an extended supply drug program serving all 50 states, Washington, D.C., and Puerto Rico. Marley Drug is committed to improving the health status of its patients and the communities it serves while reducing overall health care costs for employers and other health care consumers.

We seek Safe Harbor.