Drug interactions
Lomitapide + Sirolimus
Severity: Moderate
Lomitapide and Sirolimus: moderate 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
Sirolimus may increase lomitapide exposure via CYP3A4, and lomitapide may raise sirolimus levels via P-gp. Higher lomitapide levels raise the risk of hepatotoxicity and gastrointestinal effects.
What this interaction means in plain words
Lomitapide and Sirolimus can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Lomitapide belongs to Cardiovascular; Sirolimus belongs to Miscellaneous.
Why it happens
Bidirectional effects: weak CYP3A4 inhibition by sirolimus raises lomitapide and P-gp inhibition by lomitapide raises sirolimus.
What to do
Monitor sirolimus trough levels and liver enzymes, reduce the sirolimus dose if levels rise, and keep the lomitapide dose at or below 30 mg daily.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus 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 Sirolimus?
MediHelp rates the interaction as moderate. Lomitapide and Sirolimus can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Sirolimus may increase lomitapide exposure via CYP3A4, and lomitapide may raise sirolimus levels via P-gp. Higher lomitapide levels raise the risk of hepatotoxicity and gastrointestinal effects.
How serious is the interaction between Lomitapide and Sirolimus?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sirolimus trough levels and liver enzymes, reduce the sirolimus dose if levels rise, and keep the lomitapide dose at or below 30 mg daily.
What other medicines interact with Sirolimus?
MediHelp also lists interactions of Sirolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Sirolimus page.
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