Drug interactions
Lomitapide + Metronidazole
Severity: Major
Lomitapide and Metronidazole: 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
Metronidazole is a weak-to-moderate CYP3A4 inhibitor and can raise lomitapide exposure, increasing the risk of hepatotoxicity and gastrointestinal adverse effects. Lomitapide labeling limits use with weak CYP3A4 inhibitors and prohibits moderate and strong ones.
What this interaction means in plain words
Lomitapide and Metronidazole 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.
Lomitapide belongs to Cardiovascular; Metronidazole belongs to Anti Parasitic.
Why it happens
Inhibition of CYP3A4-mediated metabolism of lomitapide.
What to do
Avoid concurrent use where possible, or reduce the lomitapide dose per labeling and monitor liver enzymes; consider temporarily holding lomitapide during short metronidazole courses.
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 Metronidazole
- Ethanol + Metronidazole Contraindicated
- Metronidazole + Pimozide Contraindicated
- Amiodarone + Metronidazole Major
- Disulfiram + Metronidazole Major
- Ergotamine + Metronidazole Major
- Lonafarnib + Metronidazole Major
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 Lomitapide with Metronidazole?
MediHelp rates the interaction as major. Lomitapide and Metronidazole 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. Metronidazole is a weak-to-moderate CYP3A4 inhibitor and can raise lomitapide exposure, increasing the risk of hepatotoxicity and gastrointestinal adverse effects. Lomitapide labeling limits use with weak CYP3A4 inhibitors and prohibits moderate and strong ones.
How serious is the interaction between Lomitapide and Metronidazole?
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 concurrent use where possible, or reduce the lomitapide dose per labeling and monitor liver enzymes; consider temporarily holding lomitapide during short metronidazole courses.
What other medicines interact with Metronidazole?
MediHelp also lists interactions of Metronidazole with, for example, Ethanol, Pimozide, Amiodarone. The full list is on the Metronidazole page.
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