Drug interactions
Everolimus + Lonafarnib
Severity: Major
Everolimus and Lonafarnib: 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
Lonafarnib is a strong CYP3A4 inhibitor and also inhibits P-gp, so it can substantially raise everolimus exposure. This increases the risk of everolimus toxicity such as stomatitis, infection and pneumonitis.
What this interaction means in plain words
Everolimus 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.
Everolimus belongs to Oncology; Lonafarnib belongs to Miscellaneous.
Why it happens
Lonafarnib inhibits CYP3A4 and P-gp, decreasing everolimus clearance and efflux.
What to do
Avoid the combination if possible; otherwise reduce the everolimus dose and monitor trough concentrations and toxicity closely.
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 Everolimus
- Bcg vaccine live + Everolimus Contraindicated
- Everolimus + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Everolimus + Levoketoconazole Contraindicated
- Everolimus + Measles mumps and rubella vaccine live Contraindicated
- Everolimus + Measles mumps rubella and varicella vaccine live Contraindicated
- Everolimus + Measles vaccine Contraindicated
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 Everolimus with Lonafarnib?
MediHelp rates the interaction as major. Everolimus 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 CYP3A4 inhibitor and also inhibits P-gp, so it can substantially raise everolimus exposure. This increases the risk of everolimus toxicity such as stomatitis, infection and pneumonitis.
How serious is the interaction between Everolimus 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 the combination if possible; otherwise reduce the everolimus dose and monitor trough concentrations and toxicity closely.
What other medicines interact with Everolimus?
MediHelp also lists interactions of Everolimus with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Levoketoconazole. The full list is on the Everolimus page.
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