Drug interactions
Bicalutamide + Lomitapide
Severity: Major
Bicalutamide and Lomitapide: major interaction.
Last updated Sources: US FDA label
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
Bicalutamide is a weak CYP3A4 inhibitor, but lomitapide is highly sensitive to CYP3A4 inhibition, and exposure can increase substantially with hepatotoxicity risk. Lomitapide labeling restricts use with moderate and strong CYP3A4 inhibitors, and weak inhibitors require dose limits.
What this interaction means in plain words
Bicalutamide and Lomitapide 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.
Bicalutamide belongs to Endocrine; Lomitapide belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4 reduces first-pass and systemic metabolism of lomitapide.
What to do
Limit the lomitapide dose per labeling for weak CYP3A4 inhibitors and monitor liver enzymes closely; consider alternative lipid-lowering therapy.
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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References
Other interactions of Bicalutamide
- Aminolevulinic acid + Bicalutamide Moderate
- Bicalutamide + Eliglustat Moderate
- Bicalutamide + Flibanserin Moderate
- Bicalutamide + Ivosidenib Moderate
- Bicalutamide + Lonafarnib Moderate
- Bicalutamide + Mavacamten Moderate
Other interactions of Lomitapide
- Aprepitant + Lomitapide Contraindicated
- Clarithromycin + Lomitapide Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Efavirenz + Lomitapide Contraindicated
- Ensitrelvir + Lomitapide Contraindicated
Frequently asked questions
Can I take Bicalutamide with Lomitapide?
MediHelp rates the interaction as major. Bicalutamide and Lomitapide 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. Bicalutamide is a weak CYP3A4 inhibitor, but lomitapide is highly sensitive to CYP3A4 inhibition, and exposure can increase substantially with hepatotoxicity risk. Lomitapide labeling restricts use with moderate and strong CYP3A4 inhibitors, and weak inhibitors require dose limits.
How serious is the interaction between Bicalutamide and Lomitapide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit the lomitapide dose per labeling for weak CYP3A4 inhibitors and monitor liver enzymes closely; consider alternative lipid-lowering therapy.
What other medicines interact with Bicalutamide?
MediHelp also lists interactions of Bicalutamide with, for example, Aminolevulinic acid, Eliglustat, Flibanserin. The full list is on the Bicalutamide page.
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