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Drug interactions

Lonafarnib + Quinine

Severity: Major

Lonafarnib and Quinine: 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

Lonafarnib is a strong CYP3A inhibitor and can raise quinine concentrations, while quinine as a CYP3A substrate and weak inhibitor may modestly raise lonafarnib levels. Both effects increase adverse effect risk.

What this interaction means in plain words

Lonafarnib and Quinine 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; Quinine belongs to Anti Parasitic.

Evidence level: Moderate

Why it happens

Reciprocal CYP3A4 inhibition, mainly lonafarnib inhibiting quinine metabolism.

What to do

Avoid if possible. If unavoidable, monitor for quinine toxicity including QT prolongation and adjust lonafarnib per labeling.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Lonafarnib with Quinine?

MediHelp rates the interaction as major. Lonafarnib and Quinine 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 is a strong CYP3A inhibitor and can raise quinine concentrations, while quinine as a CYP3A substrate and weak inhibitor may modestly raise lonafarnib levels. Both effects increase adverse effect risk.

How serious is the interaction between Lonafarnib and Quinine?

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 if possible. If unavoidable, monitor for quinine toxicity including QT prolongation and adjust lonafarnib per labeling.

What other medicines interact with Quinine?

MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.

Full monographs, dosing and an interaction checker in the MediHelp app

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