Hello @lakehappy. In the early days of my Camzyos treatment I had a little trouble getting into the daily habit and missed a couple (single) days. Did not feel any effects. Then I had one delivery that got weather-delayed by almost a week and I would have run short. So I just decided on my own to ration what I had left over the remaining days (one every other day for about 4 days). Not ideal but it was either that or go without for the whole time. Again, no noticeable effects.

My reasoning: (i) Section 10.3 of the Camzyos monograph (https://pdf.hres.ca/dpd_pm/00074626.PDF), says that under certain conditions, the "apparent first order terminal elimination half-life" for Camzyos is about 4 days. (ii) Another source (https://www.news-medical.net/drugs/Camzyos.aspx#:~:text=tells%20you%20to.-,If%20you%20wish%20to%20stop%20taking%20Camzyos%2C%20notify%20your%20doctor,drug%20after%20you%20stop%20treatment.)says "Camzyos may remain in the body for at least 4 months after you stop treatment."

I took all this to mean that if I went for 4 full days without taking my proper dose, the amount of the drug in my system would drop by about half, but going to every other day for a few days would have a much smaller effect. Spreading what remaining doses I had available over too many days seemed the lesser of the evils. As I have stated before, this is NOT medical advise. I'm not a doctor, and I've never played one on TV. Just relaying my own experience with missed doses - while an echo might have noticed a difference, I could not feel any difference over that short time.