What Is Rezdiffra?

Rezdiffra (Resmetirom) is a once-daily prescription tablet used to treat nonalcoholic steatohepatitis (NASH), now called metabolic dysfunction-associated steatohepatitis (MASH), in adults with moderate to advanced liver fibrosis who do not have cirrhosis.

Approved by the FDA in March 2024, Rezdiffra is the first and only medication specifically approved for NASH/MASH — a condition that previously had no approved drug treatments. It was developed and is manufactured by Madrigal Pharmaceuticals, Inc.

Key Facts at a Glance

• Brand name: Rezdiffra
• Generic name: Resmetirom
• Drug class: Thyroid hormone receptor-beta (THR-β) agonist
• Manufacturer: Madrigal Pharmaceuticals, Inc.
• FDA approval: March 2024
• Controlled substance: No
• Available strengths: 60 mg, 80 mg, and 100 mg tablets
• Generic available: No

What Is Rezdiffra Used For?

Rezdiffra is approved for the treatment of noncirrhotic NASH/MASH with moderate to advanced liver fibrosis (stages F2–F3), in combination with diet and exercise.

NASH/MASH is a progressive form of fatty liver disease where excess fat in the liver causes inflammation and damage. Over time, this can lead to fibrosis (scarring), cirrhosis, liver failure, and even liver cancer. An estimated 6–8 million Americans have NASH with significant fibrosis.

Rezdiffra is not approved for:

• Simple fatty liver (steatosis) without inflammation or fibrosis
• NASH/MASH with cirrhosis (stage F4)
• Decompensated liver disease
• Pediatric patients (under 18)

Some healthcare providers may consider Rezdiffra for general NAFLD/MASLD management or dyslipidemia associated with liver disease, but these are investigational uses not covered by the FDA-approved labeling.

How Is Rezdiffra Taken?

Rezdiffra is taken as one tablet by mouth, once daily, with or without food. The tablet should be swallowed whole.

Your dose depends on your body weight:

• Under 220 lbs (100 kg): 80 mg once daily
• 220 lbs (100 kg) or more: 100 mg once daily

In some cases, your doctor may reduce your dose to 60 mg if you're also taking certain medications that interact with Rezdiffra, such as OATP1B1/1B3 inhibitors (e.g., Cyclosporine). For a complete list of interactions, see our post on Rezdiffra drug interactions.

Tips for Taking Rezdiffra

• Take it at the same time each day to maintain consistent levels in your body
• If you miss a dose, take it as soon as you remember. If it's close to your next dose, skip the missed one — don't double up
• Continue taking Rezdiffra along with the diet and exercise plan your doctor recommends
• Keep up with all scheduled lab work and follow-up appointments

Who Should Not Take Rezdiffra?

Rezdiffra is not recommended for patients with:

• Hypersensitivity to Resmetirom or any of its inactive ingredients
• Decompensated cirrhosis or severe hepatic impairment

Additionally, use caution if you are:

• Pregnant or planning to become pregnant — Safety has not been established
• Breastfeeding — It's unknown whether Resmetirom passes into breast milk
• Taking Gemfibrozil (a strong CYP2C8 inhibitor) — Concurrent use is not recommended
• Taking high-dose statins — Dose limits apply for Atorvastatin, Pravastatin, Rosuvastatin, and Simvastatin when used with Rezdiffra

Always tell your doctor about all the medications, supplements, and over-the-counter products you're taking before starting Rezdiffra. For more on what to watch out for, see Rezdiffra side effects.

How Much Does Rezdiffra Cost?

Rezdiffra is a high-cost specialty medication. Without insurance, expect to pay approximately:

• $3,950–$4,116 per month
• ~$47,400 per year at wholesale acquisition cost

There is no generic version of Rezdiffra available.

Ways to Save

• Madrigal Copay Savings Card: Eligible commercially insured patients may pay as little as $0 per fill. Not valid for Medicare, Medicaid, or other government programs. Enroll at rezdiffra.com/copay-sign-up or call 1-877-219-7770.
• Madrigal Patient Support: Offers benefits investigation, prior authorization help, and financial assistance. Call 1-877-219-7770 or visit madrigalpatientsupport.com.
• Insurance coverage: Most major commercial and Medicare plans cover Rezdiffra with prior authorization. Expect requirements including confirmed NASH/MASH diagnosis and documented fibrosis staging.

For a full breakdown of savings options, read our guide on how to save money on Rezdiffra.

Final Thoughts

Rezdiffra represents a major breakthrough for patients with NASH/MASH — a condition that went decades without an approved treatment. If you've been diagnosed with moderate to advanced liver fibrosis and your doctor has recommended Rezdiffra, understanding the basics of how it works, how to take it, and what it costs puts you in a stronger position to manage your treatment.

To learn how Rezdiffra works at the molecular level in plain English, check out our post on how Rezdiffra works. And when you're ready to fill your prescription, use Medfinder to find a pharmacy with availability.