Drug interactions
Lonafarnib + Midazolam
Severity: Contraindicated
Lonafarnib and Midazolam: contraindicated 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
Lonafarnib is a strong CYP3A inhibitor and significantly raises exposure to sensitive substrates such as midazolam, risking deep sedation and respiratory depression.
What this interaction means in plain words
Lonafarnib and Midazolam are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Lonafarnib belongs to Miscellaneous; Midazolam belongs to Central Nervous System.
Why it happens
Lonafarnib inhibits CYP3A4, impairing midazolam metabolism.
What to do
Avoid coadministration. If midazolam is required, hold lonafarnib for the interval specified in labeling (about 10-14 days before and 2 days after).
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
Other interactions of Midazolam
- Atazanavir + Midazolam Contraindicated
- Cobicistat + Midazolam Contraindicated
- Darunavir + Midazolam Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Midazolam Contraindicated
- Fosamprenavir + Midazolam Contraindicated
- Indinavir + Midazolam Contraindicated
Other interactions of Lonafarnib
- Alfuzosin + Lonafarnib Contraindicated
- Amobarbital + Lonafarnib Contraindicated
- Apalutamide + Lonafarnib Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Carbamazepine + Lonafarnib Contraindicated
- Clarithromycin + Lonafarnib Contraindicated
Frequently asked questions
Can I take Lonafarnib with Midazolam?
MediHelp rates the interaction as contraindicated. Lonafarnib and Midazolam are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Lonafarnib is a strong CYP3A inhibitor and significantly raises exposure to sensitive substrates such as midazolam, risking deep sedation and respiratory depression.
How serious is the interaction between Lonafarnib and Midazolam?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid coadministration. If midazolam is required, hold lonafarnib for the interval specified in labeling (about 10-14 days before and 2 days after).
What other medicines interact with Midazolam?
MediHelp also lists interactions of Midazolam with, for example, Atazanavir, Cobicistat, Darunavir. The full list is on the Midazolam page.
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