Drug interactions
Lonafarnib + Verapamil
Severity: Contraindicated
Lonafarnib and Verapamil: contraindicated 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 sensitive CYP3A4 substrate, and verapamil as a moderate CYP3A4 inhibitor can substantially increase its exposure. This raises the risk of lonafarnib toxicity, including gastrointestinal effects, renal and hepatic toxicity, and QT-related concerns. Labeling advises against use with moderate or strong CYP3A4 inhibitors.
What this interaction means in plain words
Lonafarnib and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP3A4, reducing the metabolic clearance of lonafarnib.
What to do
Avoid the combination and select a non-CYP3A4-inhibiting alternative to verapamil. If unavoidable, follow labeling dose-reduction guidance and monitor closely for toxicity.
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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Other interactions of Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
- Alfentanil + Verapamil 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 Verapamil?
MediHelp rates the interaction as contraindicated. Lonafarnib and Verapamil 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 sensitive CYP3A4 substrate, and verapamil as a moderate CYP3A4 inhibitor can substantially increase its exposure. This raises the risk of lonafarnib toxicity, including gastrointestinal effects, renal and hepatic toxicity, and QT-related concerns. Labeling advises against use with moderate or strong CYP3A4 inhibitors.
How serious is the interaction between Lonafarnib and Verapamil?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and select a non-CYP3A4-inhibiting alternative to verapamil. If unavoidable, follow labeling dose-reduction guidance and monitor closely for toxicity.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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