Drug interactions
Lomitapide + Valproic acid
Severity: Major
Lomitapide and Valproic acid: 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
Both drugs can cause liver injury, and lomitapide labeling warns of hepatotoxicity with other hepatotoxic agents. Valproate is not a meaningful CYP3A4 inhibitor, so the concern is additive hepatotoxicity and not increased lomitapide levels.
What this interaction means in plain words
Lomitapide and Valproic acid 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; Valproic acid belongs to Central Nervous System.
Why it happens
Additive hepatotoxicity; lomitapide causes hepatic fat accumulation and transaminase elevations while valproate can cause hepatocellular injury.
What to do
Monitor ALT, AST and bilirubin before and during therapy, following lomitapide labeling, and hold or reduce lomitapide if transaminases rise. Consider an alternative anticonvulsant if liver injury occurs.
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 Valproic acid
- Ertapenem + Valproic acid Contraindicated
- Imipenem / cilastatin / relebactam + Valproic acid Contraindicated
- Imipenem / cilastatin + Valproic acid Contraindicated
- Meropenem / vaborbactam + Valproic acid Contraindicated
- Meropenem + Valproic acid Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Valproic acid 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 Valproic acid?
MediHelp rates the interaction as major. Lomitapide and Valproic acid 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. Both drugs can cause liver injury, and lomitapide labeling warns of hepatotoxicity with other hepatotoxic agents. Valproate is not a meaningful CYP3A4 inhibitor, so the concern is additive hepatotoxicity and not increased lomitapide levels.
How serious is the interaction between Lomitapide and Valproic acid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ALT, AST and bilirubin before and during therapy, following lomitapide labeling, and hold or reduce lomitapide if transaminases rise. Consider an alternative anticonvulsant if liver injury occurs.
What other medicines interact with Valproic acid?
MediHelp also lists interactions of Valproic acid with, for example, Ertapenem, Imipenem / cilastatin / relebactam, Imipenem / cilastatin. The full list is on the Valproic acid page.
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