Resmetirom: First Treatment for NASH / Fatty Liver
Resmetirom is a first-in-class oral medication specifically developed for the treatment of nonalcoholic steatohepatitis (NASH), also known as metabolic dysfunction-associated steatohepatitis (MASH) — a form of fatty liver disease. It works as a selective thyroid hormone receptor beta (THR-β) agonist, targeting receptors found primarily in the liver.
In simple terms, resmetirom activates natural fat-processing mechanisms in the liver, helping to reduce inflammation, fat buildup, and slow the progression of fibrosis (scarring). Importantly, it has minimal effects on the thyroid gland, heart, and bones, unlike conventional thyroid hormones. On Unifarm, you can find generic versions of medications (such as Rezdiffra) containing this active ingredient.
Indications
- Nonalcoholic Steatohepatitis (NASH) with Liver Fibrosis: Treatment of adults with NASH (metabolic dysfunction-associated steatohepatitis — MASH) accompanied by moderate-to-advanced liver fibrosis (stages F2–F3) without cirrhosis. Used in combination with diet and exercise.
Important: Resmetirom is the first medication ever approved specifically for the treatment of NASH/MASH. Previously, no registered drug therapies existed for this condition.
Dosage and administration
Available as tablets taken by mouth.
How to take it:
- Patients weighing less than 100 kg: 80 mg once daily.
- Patients weighing 100 kg or more: 100 mg once daily.
- How to take: Swallow the tablet whole with water. Take in the morning with food.
Before starting treatment, your doctor will run blood tests to check your liver and thyroid function. These tests need to be repeated regularly during treatment. The medication is taken on an ongoing basis — it is not a short course but works with long-term use alongside a healthy lifestyle.
- Allergy (hypersensitivity) to resmetirom or any ingredient in the tablet.
- Decompensated liver cirrhosis (advanced liver disease with severe loss of liver function).
- Pregnancy and breastfeeding — the drug may harm the baby. Women of childbearing age must use reliable contraception.
- Untreated thyroid disorders — thyroid hormone levels must be normalized before starting treatment.
Resmetirom is generally well tolerated. Most side effects are mild to moderate. The most common ones include:
- Digestive system: Diarrhea and nausea (the most common side effects, especially at the start of treatment — usually improve over time), abdominal pain, vomiting.
- Thyroid: Mild decrease in thyroid-stimulating hormone (TSH) — your doctor will monitor this. Usually not clinically significant.
- Liver: Temporary elevation of liver markers in blood tests. This does not always indicate worsening — but requires monitoring.
- Gallbladder: Gallstones or related conditions (uncommon). Tell your doctor if you experience pain in the upper right abdomen.
- General well-being: Dizziness, headache, tiredness.
- Musculoskeletal: Muscle pain, joint pain.
Always tell your doctor about any changes in how you feel, especially abdominal pain, yellowing of skin or eyes, or severe fatigue.
