Drug interactions
Cyclosporin + Lomitapide
Severity: Major
Cyclosporin 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
Cyclosporin can raise lomitapide exposure, increasing the risk of hepatotoxicity and gastrointestinal adverse effects. Lomitapide may also increase cyclosporin exposure through P-glycoprotein inhibition.
What this interaction means in plain words
Cyclosporin 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.
Cyclosporin belongs to Miscellaneous; Lomitapide belongs to Cardiovascular.
Why it happens
Cyclosporin inhibits CYP3A4 metabolism of lomitapide, and lomitapide inhibits P-glycoprotein, which may increase cyclosporin concentrations.
What to do
Avoid the combination where possible, as lomitapide labeling restricts use with CYP3A4 inhibitors. If unavoidable, lower the lomitapide dose, monitor liver enzymes closely, and follow cyclosporin trough concentrations.
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 Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
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 Cyclosporin with Lomitapide?
MediHelp rates the interaction as major. Cyclosporin 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. Cyclosporin can raise lomitapide exposure, increasing the risk of hepatotoxicity and gastrointestinal adverse effects. Lomitapide may also increase cyclosporin exposure through P-glycoprotein inhibition.
How serious is the interaction between Cyclosporin 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: Avoid the combination where possible, as lomitapide labeling restricts use with CYP3A4 inhibitors. If unavoidable, lower the lomitapide dose, monitor liver enzymes closely, and follow cyclosporin trough concentrations.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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