Linagliptin and Lomitapide: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lomitapide
No brand names on recordLinagliptin
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.
What happens
Increased lomitapide exposure and an increased P-gp substrate exposure
Interaction Deep Dive
Concomitant use of lomitapide and weak CYP3A4 inhibitors that are also P-gp substrates may result in increased lomitapide and P-gp substrates exposure. Consider dose reduction of the P-gp substrate when used concomitantly with lomitapide. Recommended maximum lomitapide dosage with concomitant weak CYP3A4 inhibitor is 10 mg for 2 to 10 years, 20 mg for 11 to 17 years and 30 mg for 18 years and older. And titration schedule with concomitant weak CYP3A4 inhibitor as followed: Age 2 to 10 years: Titration progresses from 2 mg (weeks 0 to 8), 5 mg (weeks 9 to 12), 10 mg (weeks 13 to 16), to 20 mg starting week 17 and beyond. Higher doses are not recommended. For age 11 to 15 years: Titration begins at 2 mg (weeks 0 to 4), then 5 mg (weeks 5 to 8), 10 mg (weeks 9 to 12), 20 mg (weeks 13 to 16), and 40 mg starting week 17 and beyond. The 60 mg dose is not recommended. For age 16 to 17 years: Begins with 2 mg (weeks 0 to 2), 5 mg (weeks 3 to 6), 10 mg (weeks 7 to 10), 20 mg (weeks 11 to 14), and 40 mg starting week 15 and beyond. The 60 mg dose is not recommended. For age 18 years and older: Same titration pattern as the 16 to 17 group, 60 mg dose is allowed after week 15. Weak CYP3A4 inhibitor initiation in patients treated with a stable dosage of lomitapide, the dose of lomitapide should be reduced by half. Careful titration may then be considered based on LDL-C response and safety/tolerability to half the maximum recommended dosage except when coadministered with oral contraceptives only, in which case the maximum recommended lomitapide dose is approximately two thirds the maximum recommended dose1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of lomitapide; inhibition of P-gp-mediated efflux transport by lomitapide
Literature reports
1 report — tap to read
a) The concomitant administration of the weak CYP3A4 inhibitor atorvastatin 80 mg daily with a single 20-mg dose of lomitapide increased the AUC of lomitapide 2-fold and Cmax 2.1-fold compared with lomitapide administered alone 2.
Common questions
Can I take Linagliptin and Lomitapide together?
Increased lomitapide exposure and an increased P-gp substrate exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Linagliptin and Lomitapide 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 Linagliptin or Lomitapide 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 (2)
Keep reading about Lomitapide
Keep reading about Linagliptin
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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