Drug interactions
Lonafarnib + Upadacitinib
Severity: Major
Lonafarnib and Upadacitinib: 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 upadacitinib plasma concentrations. Higher exposure may increase dose-related JAK inhibitor adverse effects such as serious infections, cytopenias and lipid elevations.
What this interaction means in plain words
Lonafarnib and Upadacitinib 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; Upadacitinib belongs to Musculoskeletal.
Why it happens
Lonafarnib inhibits CYP3A4, the main metabolic pathway of upadacitinib, reducing its clearance.
What to do
Avoid the combination where possible. If it cannot be avoided, use the lowest labeled upadacitinib dose for the indication and monitor for infections and laboratory abnormalities.
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 Upadacitinib
- Abrocitinib + Upadacitinib Contraindicated
- Adenovirus types 4 and 7 live + Upadacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Bcg vaccine live + Upadacitinib Contraindicated
- Cyclosporine + Upadacitinib Contraindicated
- Dengue vaccine + Upadacitinib 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 Upadacitinib?
MediHelp rates the interaction as major. Lonafarnib and Upadacitinib 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 upadacitinib plasma concentrations. Higher exposure may increase dose-related JAK inhibitor adverse effects such as serious infections, cytopenias and lipid elevations.
How serious is the interaction between Lonafarnib and Upadacitinib?
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. If it cannot be avoided, use the lowest labeled upadacitinib dose for the indication and monitor for infections and laboratory abnormalities.
What other medicines interact with Upadacitinib?
MediHelp also lists interactions of Upadacitinib with, for example, Abrocitinib, Adenovirus types 4 and 7 live, Baricitinib. The full list is on the Upadacitinib page.
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