Drug interactions
Lonafarnib + Zileuton
Severity: Major
Lonafarnib and Zileuton: 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 sensitive CYP3A substrate, so even weak inhibitors such as zileuton may raise its exposure. This could increase gastrointestinal toxicity, liver enzyme elevations and potentially cardiac effects.
What this interaction means in plain words
Lonafarnib and Zileuton 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; Zileuton belongs to Respiratory.
Why it happens
Zileuton inhibition of CYP3A4 metabolism of lonafarnib.
What to do
Avoid if possible; if unavoidable, keep lonafarnib at the starting or a reduced dose and monitor for GI toxicity, liver tests and cardiac symptoms. Resume the usual dosing plan after zileuton is stopped.
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 Zileuton
- Fezolinetant + Zileuton Contraindicated
- Pimozide + Zileuton Contraindicated
- Alosetron + Zileuton Major
- Clozapine + Zileuton Major
- Lomitapide + Zileuton Major
- Theophylline + Zileuton 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 Zileuton?
MediHelp rates the interaction as major. Lonafarnib and Zileuton 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 sensitive CYP3A substrate, so even weak inhibitors such as zileuton may raise its exposure. This could increase gastrointestinal toxicity, liver enzyme elevations and potentially cardiac effects.
How serious is the interaction between Lonafarnib and Zileuton?
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, keep lonafarnib at the starting or a reduced dose and monitor for GI toxicity, liver tests and cardiac symptoms. Resume the usual dosing plan after zileuton is stopped.
What other medicines interact with Zileuton?
MediHelp also lists interactions of Zileuton with, for example, Fezolinetant, Pimozide, Alosetron. The full list is on the Zileuton page.
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