Drug Interaction Report

Aripiprazole Injection and Lonafarnib: Interaction Details

Name: Aripiprazole Injection and Lonafarnib Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Aripiprazole Injection and Lonafarnib interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Lonafarnib

Zokinvy

Aripiprazole Injection

Abilify Abilify Maintena® Abilify® Aristad Initio® Aristada® Opipza

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Jul 11, 2026

Editorial policy · Data sources

Interaction severity

Major

Potentially serious — often needs a change or close monitoring.

Minor

Moderate

Major

Contraindicated

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.

Of 347 documented Aripiprazole Injection interactions, 316 are rated major — including this one.

Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.

Onset

unspecified

Evidence

theoretical

Severity

Major

What happens

Increased ARIPiprazole exposure and an increased risk of QT interval prolongation and torsade de pointes

Interaction Deep Dive

Avoid concomitant use of lonafarnib with ARIPiprazole as it may result in additive QT interval prolongation. Monitor ECGs when initiating and during concomitant use⁴. Reduce the ARIPiprazole dose to 50% of its usual dose in patients receiving lonafarnib ². If lonafarnib use exceeds 14 days, reduce ARIPiprazole IM dose 400 mg to 300 mg, 300 mg to 200 mg. If coadministered for less than 14 days, then no dose adjustment is needed. Increase ARIPiprazole dose after stopping lonafarnib ³. Avoid ARIPiprazole extended release 2-months injection use in patients on lonafarnib, use 720 mg once every 2 months ¹. If coadministered, reduce Aristada(R) to the next lower strength, no dose change for 441 mg monthly is needed if tolerated ⁵.

Why it happens (mechanism)

Inhibition of CYP3A-mediated metabolism of ARIPiprazole; additive QT interval prolongation

Literature reports

1 report — tap to read

a) Concomitant use of ARIPiprazole with ketoconazole resulted in increased AUC and Cmax of ARIPiprazole by 1.6-fold and 1.4-fold, respectively. Concomitant use also increased the AUC and Cmax of dehydro-ARIPiprazole by 1.7-fold and 1.5-fold, respectively ³¹.

Common questions

Can I take Aripiprazole Injection and Lonafarnib together?

Increased ARIPiprazole exposure and an increased risk of QT interval prolongation and torsade de pointes Always confirm with your pharmacist or prescriber before making any change.

How serious is the Aripiprazole Injection and Lonafarnib interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

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 Aripiprazole Injection or Lonafarnib 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 (5)

Product Information: ABILIFY ASIMTUFII(R) intramuscular extended-release suspension, aripiprazole intramuscular extended-release suspension. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2023.
Product Information: ABILIFY(R) oral tablets, oral solution, intramuscular injection, aripiprazole oral tablets, oral solution, intramuscular injection. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2022. DailyMed
Product Information: ABILIFY MAINTENA(R) intramuscular extended-release injection, aripiprazole intramuscular extended-release injection. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2020.
Product Information: ZOKINVY(TM) oral capsules, lonafarnib oral capsules. Eiger BioPharmaceuticals Inc (per FDA), Palo Alto, CA, 2024. DailyMed
Product Information: ARISTADA(R) intramuscular extended-release injection, aripiprazole lauroxil intramuscular extended-release injection. Alkermes Inc (per FDA), Waltham, MA, 2018.

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Lonafarnib

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Aripiprazole Injection

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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Lonafarnib + Activated Charcoal Asarabacca Grapefruit Siberian Cocklebur St. John's Wort Acacia Rigidula Adrafinil African Wild Potato + 152 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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A message from HelloPharmacist

About our interaction database: depth, not breadth

HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.