Drug interactions
Lomitapide + Tolvaptan
Severity: Moderate
Lomitapide and Tolvaptan: 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
Lomitapide inhibits P-glycoprotein and can increase tolvaptan concentrations. Higher tolvaptan exposure raises the risk of excessive water loss and too rapid correction of sodium. Both drugs also carry hepatotoxicity warnings.
What this interaction means in plain words
Lomitapide and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
P-glycoprotein inhibition by lomitapide reduces tolvaptan efflux and clearance.
What to do
Monitor serum sodium, volume status and liver enzymes, and reduce the tolvaptan dose if adverse effects occur.
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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan 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 Tolvaptan?
MediHelp rates the interaction as moderate. Lomitapide and Tolvaptan 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 inhibits P-glycoprotein and can increase tolvaptan concentrations. Higher tolvaptan exposure raises the risk of excessive water loss and too rapid correction of sodium. Both drugs also carry hepatotoxicity warnings.
How serious is the interaction between Lomitapide and Tolvaptan?
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 serum sodium, volume status and liver enzymes, and reduce the tolvaptan dose if adverse effects occur.
What other medicines interact with Tolvaptan?
MediHelp also lists interactions of Tolvaptan with, for example, Atazanavir, Ceritinib, Cobicistat. The full list is on the Tolvaptan page.
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