Abametapir and Domperidone: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jun 30, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abametapir
No brand names on recordDomperidone
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Abametapir is a lotion used to treat head lice. Even though it goes on your scalp, a little bit gets into your body and can briefly slow down a liver enzyme called CYP3A4. That enzyme is one of the main ways your body breaks down domperidone, a medicine for nausea and stomach problems.
When that enzyme is slowed, domperidone can build up higher than usual. That matters because higher domperidone levels can affect the heart's rhythm. The good news is this is a short-term concern and easy to plan around. Talk with your pharmacist or doctor about the timing of your lice treatment so they can keep you safe.
Mechanism: Abametapir is a CYP3A4 inhibitor; domperidone is a CYP3A4 substrate. Concomitant use is predicted to reduce domperidone clearance and increase its systemic exposure (AUC/Cmax).
Clinical relevance: Elevated domperidone concentrations raise the risk of QT prolongation and ventricular arrhythmia, a recognized dose- and concentration-dependent effect.
- Direction: increased domperidone effect (neither drug is a prodrug here)
- Onset: rapid
- Evidence: theoretical, based on CYP3A4 inhibition
- Management: Avoid CYP3A4 substrates for 2 weeks after abametapir application; if unavoidable, avoid abametapir.
What happens
Increased exposure of CYP3A4 substrate
Interaction Deep Dive
During the 2 weeks following abametapir application, refrain from using CYP3A4 substrates. Should that not be practical, abametapir itself should be avoided 1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism by abametapir
How to manage this interaction
Both medicines can usually be used safely with a little planning. The main step your care team takes here is timing and separation, not a dose change.
- The guidance on file is to avoid CYP3A4 substrates like domperidone for 2 weeks after applying abametapir.
- If avoiding domperidone during that window is not feasible, the alternative is to avoid using abametapir.
- Keep taking your medicines as prescribed and do not stop anything on your own.
- Before using an abametapir lice treatment, tell your pharmacist or prescriber you take domperidone so they can help you plan the timing or choose an alternative.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abametapir and Domperidone together?
Abametapir can raise domperidone levels for about 2 weeks, which may increase heart-rhythm risk, so separate them or use an alternative. Check with your pharmacist or doctor before starting the lice treatment. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abametapir and Domperidone interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Abametapir and Domperidone interaction managed?
Both medicines can usually be used safely with a little planning. The main step your care team takes here is timing and separation, not a dose change. The guidance on file is to avoid CYP3A4 substrates like domperidone for 2 weeks after applying abametapir. If avoiding domperidone during that window is not feasible, the alternative is to avoid using abametapir. Keep taking your medicines as prescr… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abametapir or Domperidone need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: XEGLYZE(TM) topical lotion, abametapir topical lotion. Dr Reddy’s Laboratories Inc (per FDA), Princeton, NJ, 2020. DailyMed
Keep reading about Abametapir
Keep reading about Domperidone
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