Drug interactions
Lonafarnib + Sirolimus
Severity: Major
Lonafarnib and Sirolimus: 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 inhibits CYP3A and can raise sirolimus levels, and sirolimus as a weak CYP3A inhibitor may raise lonafarnib exposure. Both drugs are sensitive to CYP3A changes, so toxicity of either is possible.
What this interaction means in plain words
Lonafarnib and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Mutual CYP3A4 inhibition, with lonafarnib the stronger inhibitor, reduces metabolism of both drugs.
What to do
Avoid if possible. If combined, reduce the sirolimus dose, monitor trough levels, and follow lonafarnib labeling for dose reduction while watching for adverse effects.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus 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 Sirolimus?
MediHelp rates the interaction as major. Lonafarnib and Sirolimus 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 inhibits CYP3A and can raise sirolimus levels, and sirolimus as a weak CYP3A inhibitor may raise lonafarnib exposure. Both drugs are sensitive to CYP3A changes, so toxicity of either is possible.
How serious is the interaction between Lonafarnib and Sirolimus?
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 combined, reduce the sirolimus dose, monitor trough levels, and follow lonafarnib labeling for dose reduction while watching for adverse effects.
What other medicines interact with Sirolimus?
MediHelp also lists interactions of Sirolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Sirolimus page.
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