Drug interactions
Lonafarnib + Netupitant-palonosetron
Severity: Major
Lonafarnib and Netupitant-palonosetron: 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
Netupitant is a moderate CYP3A4 inhibitor, and lonafarnib is a sensitive CYP3A4 substrate. Coadministration can substantially increase lonafarnib exposure and raise the risk of adverse effects such as gastrointestinal toxicity, electrolyte disturbance and QT effects.
What this interaction means in plain words
Lonafarnib and Netupitant-palonosetron 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.
Lonafarnib belongs to Miscellaneous; Netupitant-palonosetron belongs to Gastrointestinal Tract.
Why it happens
Inhibition of CYP3A4 by netupitant decreases the metabolism of lonafarnib.
What to do
Avoid the combination where possible and use an antiemetic regimen without a CYP3A4 inhibitor. If it cannot be avoided, reduce the lonafarnib dose per labeling and monitor for toxicity.
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 Netupitant-palonosetron
- Apomorphine + Netupitant-palonosetron Contraindicated
- Flibanserin + Netupitant-palonosetron Contraindicated
- Apalutamide + Netupitant-palonosetron Major
- Avapritinib + Netupitant-palonosetron Major
- Carbamazepine + Netupitant-palonosetron Major
- Cobimetinib + Netupitant-palonosetron Major
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 Netupitant-palonosetron?
MediHelp rates the interaction as major. Lonafarnib and Netupitant-palonosetron 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. Netupitant is a moderate CYP3A4 inhibitor, and lonafarnib is a sensitive CYP3A4 substrate. Coadministration can substantially increase lonafarnib exposure and raise the risk of adverse effects such as gastrointestinal toxicity, electrolyte disturbance and QT effects.
How serious is the interaction between Lonafarnib and Netupitant-palonosetron?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and use an antiemetic regimen without a CYP3A4 inhibitor. If it cannot be avoided, reduce the lonafarnib dose per labeling and monitor for toxicity.
What other medicines interact with Netupitant-palonosetron?
MediHelp also lists interactions of Netupitant-palonosetron with, for example, Apomorphine, Flibanserin, Apalutamide. The full list is on the Netupitant-palonosetron page.
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