Drug interactions
Aprepitant + Lemborexant
Severity: Major
Aprepitant and Lemborexant: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Aprepitant can raise lemborexant exposure through CYP3A4 inhibition. This may cause excess somnolence, next-day impairment and impaired driving ability.
What this interaction means in plain words
Aprepitant and Lemborexant can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Aprepitant belongs to Gastrointestinal Tract; Lemborexant belongs to Central Nervous System.
Why it happens
Aprepitant inhibits CYP3A4, reducing lemborexant clearance.
What to do
Avoid combining where possible as labeling advises against moderate CYP3A inhibitors. If unavoidable, use the lowest lemborexant dose (5 mg) and counsel about next-day sedation.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Lemborexant
Frequently asked questions
Can I take Aprepitant with Lemborexant?
MediHelp rates the interaction as major. Aprepitant and Lemborexant can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Aprepitant can raise lemborexant exposure through CYP3A4 inhibition. This may cause excess somnolence, next-day impairment and impaired driving ability.
How serious is the interaction between Aprepitant and Lemborexant?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining where possible as labeling advises against moderate CYP3A inhibitors. If unavoidable, use the lowest lemborexant dose (5 mg) and counsel about next-day sedation.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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