Drug Interactions between lonafarnib and sirolimus protein-bound

Lonafarnib should be taken with the morning and evening meals and an adequate amount of water. Do not consume grapefruit, grapefruit juice, or Seville oranges (also known as bitter or sour oranges).During treatment with lonafarnib. Juice from grapefruits and Seville oranges can increase the blood levels of lonafarnib. This may increase the risk and/or severity of side effects such as nausea, vomiting, diarrhea, loss of appetite, electrolyte (e.G., calcium, magnesium, potassium, phosphate, sodium) abnormalities, liver problems, low red and white blood cell counts, infection, and high blood pressure. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Grapefruit juice may increase the blood levels of sirolimus protein-bound. However, this has not been studied, and it is not known to what extent grapefruit juice may interact with sirolimus protein-bound. High blood levels of sirolimus protein-bound can increase side effects such as mouth sores and inflammation, nausea, diarrhea, vomiting, abdominal pain, decreased appetite, increased blood sugar, rash, hair loss, lung or breathing problems, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. The manufacturer recommends avoiding grapefruit and grapefruit juice during treatment with sirolimus protein-bound. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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