Drug Interactions between lomitapide and sonidegib

Taking lomitapide with food may increase gastrointestinal side effects such as diarrhea, nausea, vomiting, stomach pain or discomfort, constipation, indigestion, and 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, and/or yellowing of the skin or eyes, as 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.

Sonidegib should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal. The presence of food can significantly increase the absorption of sonidegib into the blood stream. This may increase side effects such as muscle spasms, muscle pain, muscle weakness, fatigue, nausea, vomiting, diarrhea, loss of appetite, weight loss, hair loss, itching, and taste abnormalities. You may also have an increased risk of developing a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with sonidegib, especially if these symptoms are accompanied by fever or dark colored urine. Grapefruit juice may also increase the blood levels of sonidegib and should be avoided. Talk to your doctor or pharmacist if you have any questions or concerns.