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Can you take Lonafarnib with Lumakras?

1 drug interaction and 6 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

lonafarnib sotorasib

Applies to: lonafarnib and Lumakras (sotorasib)

Using lonafarnib together with sotorasib is not recommended.

Combining these medications may significantly reduce the blood levels of lonafarnib, which may make the medication ineffective or less effective in treating your condition.

Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact.

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:

lonafarnib Food/Lifestyle

Applies to: lonafarnib

Consuming grapefruit, grapefruit juice, grapefruit hybrids, starfruit, and Seville oranges (also known as bitter or sour oranges) during treatment with lonafarnib is not recommended. Doing so may significantly increase the blood levels and effects of lonafarnib.

This may increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening.

You may be more susceptible if you have:

  • a heart condition called congenital long QT syndrome
  • other cardiac diseases
  • conduction abnormalities
  • electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)

The risk and/or severity of other side effects may also increase, including:

  • 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
  • high blood pressure

Additionally, you should take lonafarnib with the morning and evening meals and an adequate amount of water.

You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment.

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.

Minor food/lifestyle interactions

Minor:

sotorasib Food/Lifestyle

Applies to: Lumakras (sotorasib)

Food does not appear to have a clinically significant effect on the oral bioavailability of sotorasib. When a 960 mg dose of sotorasib was administered to study patients with a high-fat, high-calorie meal (approximately 800 to 1000 calories; 150, 250, and 500 to 600 calories from protein, carbohydrate, and fat, respectively), sotorasib peak plasma concentration (Cmax) did not change while systemic exposure (AUC 0-24 hours) increased by 25% compared to administration under fasted conditions. Sotorasib can be administered with or without food at approximately the same time each day.

The information above is from our professional interaction data. Consumer information is not available for this interaction.

Disease interactions

4 potential interactions Applies to: 2 conditions, including Liver Disease and Renal Dysfunction.

Liver Disease

Moderate:

lonafarnib

Lonafarnib has a moderate potential interaction with Liver Disease.

Hepatic transaminase elevations (i.e., aspartate aminotransferase AST] and alanine aminotransferase ([ALT]) have been reported during lonafarnib therapy. Often these elevations improve with continued therapy, but it is not possible to exclude this drug as a cause of the abnormalities. Liver enzymes should be monitored periodically during therapy.

Moderate:

Lumakras

The sotorasib in Lumakras has a moderate potential interaction with Liver Disease.

The effects of severe renal impairment or moderate to severe hepatic impairment on the pharmacokinetics of sotorasib have not been studied.

Renal Dysfunction

Moderate:

lonafarnib

Lonafarnib has a moderate potential interaction with Renal Dysfunction.

Lonafarnib has not been studied in patients with renal impairment, however, this drug caused nephrotoxicity in rats at plasma drug exposures approximately equal to that achieved with the human dose. Renal function should be monitored at regular intervals during therapy.

Moderate:

Lumakras

The sotorasib in Lumakras has a moderate potential interaction with Renal Dysfunction.

The effects of severe renal impairment or moderate to severe hepatic impairment on the pharmacokinetics of sotorasib have not been studied.

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More resources

lonafarnib

A total of 710 drugs are known to interact with lonafarnib.

Lumakras

A total of 537 drugs are known to interact with Lumakras.

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.

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