Drug interactions
Bortezomib + Lonafarnib
Severity: Major
Bortezomib and Lonafarnib: 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
Lonafarnib is a strong CYP3A inhibitor and may increase bortezomib exposure, worsening neuropathy and cytopenias. Lonafarnib is itself a sensitive CYP3A substrate, so inhibition by bortezomib is unlikely to be clinically relevant. Lonafarnib's QT effect is also unknown.
What this interaction means in plain words
Bortezomib and Lonafarnib 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.
Bortezomib belongs to Oncology; Lonafarnib belongs to Miscellaneous.
Why it happens
Lonafarnib inhibits CYP3A4, decreasing bortezomib clearance.
What to do
Avoid if possible; otherwise monitor for neuropathy, thrombocytopenia and arrhythmia symptoms, and consider reducing the bortezomib dose.
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 Bortezomib
- Apalutamide + Bortezomib Major
- Bortezomib + Carbamazepine Major
- Bortezomib + Etrasimod Major
- Bortezomib + Fosphenytoin Major
- Bortezomib + Idelalisib Major
- Bortezomib + Mitotane Major
Other interactions of Lonafarnib
- Alfuzosin + Lonafarnib Contraindicated
- Amobarbital + Lonafarnib Contraindicated
- Apalutamide + Lonafarnib Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Carbamazepine + Lonafarnib Contraindicated
- Clarithromycin + Lonafarnib Contraindicated
Frequently asked questions
Can I take Bortezomib with Lonafarnib?
MediHelp rates the interaction as major. Bortezomib and Lonafarnib 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. Lonafarnib is a strong CYP3A inhibitor and may increase bortezomib exposure, worsening neuropathy and cytopenias. Lonafarnib is itself a sensitive CYP3A substrate, so inhibition by bortezomib is unlikely to be clinically relevant. Lonafarnib's QT effect is also unknown.
How serious is the interaction between Bortezomib and Lonafarnib?
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 if possible; otherwise monitor for neuropathy, thrombocytopenia and arrhythmia symptoms, and consider reducing the bortezomib dose.
What other medicines interact with Bortezomib?
MediHelp also lists interactions of Bortezomib with, for example, Apalutamide, Carbamazepine, Etrasimod. The full list is on the Bortezomib page.
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