Resmetirom
Thyroid hormones
Thyroid hormones
An oral liver-directed thyroid hormone receptor-beta agonist for fatty liver inflammation with scarring (MASH), used with diet and exercise.
Quick facts
- Group
- Thyroid hormones
- Target
- Thyroid hormone receptor beta (THR-beta)
- Key effects
- Diarrhoea and nausea · Itching
- Monitor
- Liver tests during treatment
- ATC
- A05BA11
No doses: the clinician sets them by the current guideline.
Mechanism of action
Thyroid hormone acting on the beta receptor in the liver keeps the liver from building up fat. Resmetirom is a partial agonist that favours the beta receptor, so it acts on the liver while largely sparing the heart and bone, where the alpha receptor dominates. Less fat in liver cells means less inflammation and, over time, less scarring. It does not replace thyroid hormone in hypothyroidism.
- Fat builds up in liver cells and inflames them
- Resmetirom activates the liver's THR-beta
- Liver fat falls
- Inflammation and scarring can improve
Indications
- Noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH) with moderate to advanced fibrosis, with diet and exercise Metabolic dysfunction-associated steatotic liver disease (MASLD/NAFLD) →
Adverse effects
Common
- Diarrhoea and nausea, the most common
- Itching, abdominal pain, vomiting, constipation and dizziness
Contraindications
- Decompensated cirrhosis (avoided)
- Worsening liver function during treatment (stopped)
Key interactions
- Statins
- Potentially significant interaction (FDA); statin choice and dose are reviewed
What is monitored
- Liver tests during treatment
- Symptoms of liver injury: fatigue, fever, jaundice, right upper abdominal pain
- Symptoms of gallbladder disease
Administration and safety
- Given by mouth at about the same time each day
- Part of a plan that includes diet, exercise and treatment of diabetes and lipids
Pregnancy and breastfeeding
Information on use in pregnancy is limited; patients are asked to tell their doctor if they become pregnant.
Nursing care
- Ask about all medicines, especially statins
- Teach the warning signs of liver injury: yellow skin or eyes, dark urine, right upper abdominal pain
- Support weight loss and activity goals, which remain the basis of care
Pharmacokinetics
- Absorption
- Taken by mouth once a day
Test yourself
Think of the answer, then tap the question to see it.
Which receptor does resmetirom target, and why is that selective?
Thyroid hormone receptor beta, the main form in the liver; heart and bone rely more on the alpha receptor.
What condition is resmetirom approved for?
Noncirrhotic MASH (formerly NASH) with moderate to advanced liver fibrosis, together with diet and exercise.
Which drug group has a potentially significant interaction with resmetirom?
Statins.
Connections
← Back to the class: Thyroid hormones
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Resmetirom: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); FDA Approves First Treatment for Patients with Liver Scarring Due to Fatty Liver Disease (U.S. Food and Drug Administration, 2024); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.