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Can you take Lomitapide with Rilonacept?

1 drug interaction and 12 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

rilonacept lomitapide

Applies to: rilonacept and lomitapide

Rilonacept may alter the blood levels and effects of lomitapide.

Your doctor may need to monitor you more closely and/or adjust the dosing of your medication(s).

For example, a dose adjustment may be needed if you have been receiving lomitapide and are starting treatment with rilonacept. Likewise, if you have been receiving both medications, the dose of lomitapide may need to be adjusted when rilonacept is discontinued.

Contact your doctor if your condition changes or you experience increased side effects.

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.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

lomitapide Food/Lifestyle

Applies to: lomitapide

Taking lomitapide with food may increase gastrointestinal side effects such as:

  • diarrhea
  • nausea
  • vomiting
  • stomach pain or discomfort
  • constipation
  • indigestion
  • gas

The absorption of any other oral medication you may take can be affected if you develop diarrhea or vomiting.

To reduce the risk of gastrointestinal intolerance, lomitapide should be taken once daily with a glass of water, without food, at least 2 hours after the evening meal.

You should also follow a low-fat diet (<20% of total calories from fat) during treatment with lomitapide, and avoid the consumption of grapefruit or grapefruit juice.

Since lomitapide may cause injury to the liver, you should have no more than one alcoholic drink per day.

Call your doctor immediately if you have:

  • fever
  • chills
  • joint pain or swelling
  • unusual bleeding or bruising
  • skin rash
  • itching
  • loss of appetite
  • fatigue
  • nausea
  • vomiting
  • abdominal pain
  • dark colored urine
  • light colored stools
  • yellowing of the skin or eyes

These may be signs and symptoms of liver damage.

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.

Disease interactions

11 potential interactions Applies to: 9 conditions, including High Cholesterol, Liver Disease, Infection, Tuberculosis, Latent, and Alcoholism.

Alcoholism

Moderate:

lomitapide

Lomitapide has a moderate potential interaction with Alcoholism.

Alcohol may increase the levels of hepatic fat and induce or exacerbate liver injury. It is recommended that patients taking lomitapide should not consume more than one alcoholic drink per day.

Galactosemia

Moderate:

lomitapide

Lomitapide has a moderate potential interaction with Galactosemia.

Patients with rare, hereditary problems of galactose intolerance, the Lapp lactase deficiency, or glucose-galactose malabsorption should avoid lomitapide as this may result in diarrhea or malabsorption.

High Cholesterol

Moderate:

rilonacept

Rilonacept has a moderate potential interaction with High Cholesterol.

Patients treated with rilonacept experienced increases in their mean total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. The mean increases from baseline for total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were 19 mg/dL, 2 mg/dL, 10 mg/dL, and 57 mg/dL respectively after 6 weeks of open-label therapy. Physicians should monitor the lipid profiles of their patients especially those with hyperlipidemias, and consider lipid-lowering therapies as needed based upon cardiovascular risk factors and current guidelines.

Infection

Moderate:

rilonacept

Rilonacept has a moderate potential interaction with Infection.

Interleukin-1 (IL-1) blockade may interfere with the immune response to infections. Treatment with other medication as rilonacept, that work through inhibition of IL-1 has been associated with an increased risk of serious infections, and serious infections have been reported in patients taking rilonacept compared with placebo. Rilonacept should be discontinued if a patient develops a serious infection. Treatment with rilonacept should not be initiated in patients with an active or chronic infection. Additionally, latent tuberculosis can be reactivated and should be treated before initiating therapy with rilonacept.

Liver Disease

Major:

lomitapide

Lomitapide has a major potential interaction with Liver Disease.

The use of lomitapide is contraindicated in patients with moderate or severe hepatic impairment (Child-Pugh B or C), and patients with active liver disease, including unexplained elevations of serum transaminases. Lomitapide increases hepatic fat, with or without concomitant increases in transaminases. Hepatic steatosis associated with the use of lomitapide may be a risk factor for progressive liver disease including steatohepatitis and cirrhosis. Patients with mild liver impairment should not exceed 40 mg daily as exposure can increase up to 50% compared with healthy volunteers.

Moderate:

rilonacept

Rilonacept has a moderate potential interaction with Liver Disease.

No formal studies have been conducted to examine the pharmacokinetics of rilonacept administered subcutaneously in patients with hepatic impairment. Caution is advised if used on these patients.

Malabsorption Syndrome

Moderate:

lomitapide

Lomitapide has a moderate potential interaction with Malabsorption Syndrome.

Lomitapide may reduce the absorption of fat soluble nutrients. Patients on clinical trials were provided with daily dietary supplements of vitamin E, linoleic acid, alpha- linoleic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Patients with chronic bowel or pancreatic diseases that predispose to malabsorption may be at increased risk for deficiencies in these nutrients with the use of lomitapide. Patients receiving treatment should take daily vitamin supplements.

Renal Dysfunction

Moderate:

lomitapide

Lomitapide has a moderate potential interaction with Renal Dysfunction.

Patients with end-stage renal disease receiving dialysis should not exceed 40 mg daily of lomitapide, as exposure can increase up to 50% compared with healthy volunteers. Effects of mild, moderate, and severe renal impairment, including end-stage renal disease not yet receiving dialysis, on lomitapide exposure have not been studied. Caution is advised.

Moderate:

rilonacept

Rilonacept has a moderate potential interaction with Renal Dysfunction.

No formal studies have been conducted to examine the pharmacokinetics of rilonacept administered subcutaneously in patients with renal impairment. Caution is advised if used on these patients.

Tuberculosis, Latent

Moderate:

rilonacept

Rilonacept has a moderate potential interaction with Tuberculosis, Latent.

Interleukin-1 (IL-1) blockade may interfere with the immune response to infections. Treatment with other medication as rilonacept, that work through inhibition of IL-1 has been associated with an increased risk of serious infections, and serious infections have been reported in patients taking rilonacept compared with placebo. Rilonacept should be discontinued if a patient develops a serious infection. Treatment with rilonacept should not be initiated in patients with an active or chronic infection. Additionally, latent tuberculosis can be reactivated and should be treated before initiating therapy with rilonacept.

Vaccination

Major:

rilonacept

Rilonacept has a major potential interaction with Vaccination.

Live vaccines should not be given concurrently with rilonacept. Rilonacept may interfere with normal immune response to new antigens; therefore, vaccinations may not be effective in patients receiving rilonacept. No data are available on the effectiveness of vaccination with inactivated (killed) antigens in patients receiving rilonacept. Because IL-1 blockade may interfere with immune response to infections, it is recommended that prior to initiation of therapy with rilonacept adult and pediatric patients receive all recommended vaccinations, as appropriate, including pneumococcal vaccine and inactivated influenza vaccine.

More resources

lomitapide

A total of 570 drugs are known to interact with lomitapide.

rilonacept

A total of 535 drugs are known to interact with rilonacept.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.