Abametapir and Reboxetine: 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 recordReboxetine
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 you only put it on your scalp, some of it gets into your body and can slow down a liver enzyme (called CYP3A4) for up to two weeks. Reboxetine is broken down by that same enzyme.
So after using abametapir, your body may clear reboxetine more slowly, letting more of it build up. That could mean stronger side effects like a faster heartbeat, trouble sleeping, dry mouth, or feeling jittery. This is a caution based on how the drugs work, not on reports of harm. The good news is your care team can plan the timing and watch you closely, so please check with your pharmacist or doctor before combining them.
Mechanism: Abametapir inhibits CYP3A4. Reboxetine is a CYP3A4 substrate, so co-use is expected to reduce reboxetine clearance and increase its exposure (AUC/Cmax), with a rapid onset that may persist for up to 2 weeks after topical application.
- Direction: increased reboxetine exposure and potential enhanced adrenergic/noradrenergic effects (tachycardia, insomnia, dry mouth, urinary hesitancy).
- Evidence: theoretical; based on known CYP3A4 inhibition, not clinical outcome data.
- Management: Avoid CYP3A4 substrates such as reboxetine within 2 weeks of abametapir application; if unavoidable, avoid abametapir. Consider monitoring for reboxetine toxicity if co-exposure occurs.
What happens
Increased exposure of CYP3A4 substrate
Interaction Deep Dive
For a period of 2 weeks following abametapir application, refrain from administering CYP3A4 substrates. Should avoiding these substrates not be practical, abametapir itself should not be used 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 the right plan. Because abametapir can slow how your body clears reboxetine for about two weeks, your care team will focus on timing.
- Keep taking reboxetine as prescribed unless your prescriber tells you otherwise.
- Tell your pharmacist or doctor before using abametapir lice treatment so they can space the two apart or choose an alternative lice option.
- The general guidance is to avoid a CYP3A4 medicine like reboxetine within 2 weeks of applying abametapir; if that is not possible, the abametapir may be avoided instead.
- Report any new fast heartbeat, jitteriness, or sleep trouble.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abametapir and Reboxetine together?
Abametapir can raise reboxetine levels for up to two weeks by blocking the enzyme that clears it, so avoid using them together during that window and let your pharmacist or doctor coordinate timing. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abametapir and Reboxetine 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 Reboxetine interaction managed?
Both medicines can usually be used safely with the right plan. Because abametapir can slow how your body clears reboxetine for about two weeks, your care team will focus on timing. Keep taking reboxetine as prescribed unless your prescriber tells you otherwise. Tell your pharmacist or doctor before using abametapir lice treatment so they can space the two apart or choose an alternative lice option… 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 Reboxetine 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 Reboxetine
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