Drug interactions
Lomitapide + Ranolazine
Severity: Major
Lomitapide and Ranolazine: 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
Ranolazine, a weak CYP3A4 inhibitor, can raise lomitapide exposure, increasing hepatotoxicity and gastrointestinal effects. Lomitapide may also increase ranolazine levels via P-gp inhibition.
What this interaction means in plain words
Lomitapide and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Ranolazine inhibits CYP3A4 metabolism of lomitapide and lomitapide inhibits P-glycoprotein transport of ranolazine.
What to do
Limit lomitapide to 30 mg daily with weak CYP3A4 inhibitors, monitor liver enzymes, and consider reducing the ranolazine 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Lomitapide and Ranolazine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Lomitapide with Ranolazine?
MediHelp rates the interaction as major. Lomitapide and Ranolazine 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. Ranolazine, a weak CYP3A4 inhibitor, can raise lomitapide exposure, increasing hepatotoxicity and gastrointestinal effects. Lomitapide may also increase ranolazine levels via P-gp inhibition.
How serious is the interaction between Lomitapide and Ranolazine?
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 lomitapide to 30 mg daily with weak CYP3A4 inhibitors, monitor liver enzymes, and consider reducing the ranolazine dose.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
