Drug interactions
Lonafarnib + Tolvaptan
Severity: Contraindicated
Lonafarnib and Tolvaptan: 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 is expected to substantially raise tolvaptan exposure. Strong CYP3A inhibitors are contraindicated with tolvaptan due to the risk of excessive aquaresis and rapid sodium correction.
What this interaction means in plain words
Lonafarnib and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Lonafarnib strongly inhibits CYP3A4, greatly reducing tolvaptan clearance.
What to do
Do not combine; use an alternative to tolvaptan while lonafarnib is required.
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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan 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 Tolvaptan?
MediHelp rates the interaction as contraindicated. Lonafarnib and Tolvaptan 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 is expected to substantially raise tolvaptan exposure. Strong CYP3A inhibitors are contraindicated with tolvaptan due to the risk of excessive aquaresis and rapid sodium correction.
How serious is the interaction between Lonafarnib and Tolvaptan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine; use an alternative to tolvaptan while lonafarnib is required.
What other medicines interact with Tolvaptan?
MediHelp also lists interactions of Tolvaptan with, for example, Atazanavir, Ceritinib, Cobicistat. The full list is on the Tolvaptan page.
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