Sonidegib and Abametapir: 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 recordSonidegib
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 rub it on your scalp, it can affect an enzyme in your body called CYP3A4, which is the same enzyme that breaks down sonidegib (Odomzo), a medicine used for a type of skin cancer.
When abametapir slows that enzyme down, sonidegib can build up in your body and cause more side effects than expected. This is based on how the drugs work rather than on real-world reports, but it is taken seriously. The good news is your care team can manage this easily by spacing out the two treatments. Please check with your pharmacist or doctor before using both.
Interaction: Abametapir is a CYP3A4 inhibitor; sonidegib is a CYP3A4 substrate. Inhibition of CYP3A4-mediated metabolism is expected to increase sonidegib exposure (AUC/Cmax), raising the risk of dose-related toxicity.
- Direction: increased sonidegib effect/toxicity
- Onset: rapid
- Evidence: theoretical (mechanism-based)
- Magnitude: not quantified; enzyme inhibition may persist after topical abametapir application
Management: Avoid sonidegib within 2 weeks after applying abametapir. If concurrent use cannot be avoided, avoid abametapir. Monitor for sonidegib-related adverse effects if exposure is unavoidable.
What happens
Increased exposure of CYP3A4 substrate
Interaction Deep Dive
Do not administer CYP3A4 substrates during the 2 week period following the application of abametapir. Should avoiding these substrates prove impractical, then abametapir itself should not be used 1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism by abametapir
How to manage this interaction
This interaction is manageable, mainly by timing. Because abametapir can slow the breakdown of sonidegib for a while after use, the documented guidance is to keep them apart.
- Avoid starting sonidegib within 2 weeks after applying abametapir lice treatment.
- If that spacing is not feasible, the alternative is to avoid using abametapir.
- Keep taking sonidegib as prescribed unless your care team tells you otherwise.
Before using an abametapir lice product, tell your pharmacist or oncology team you take sonidegib so they can guide timing or suggest another option. Your team may also monitor you more closely if any overlap occurs.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Sonidegib and Abametapir together?
Abametapir can raise sonidegib levels and side effects, so avoid taking sonidegib within 2 weeks of using abametapir; if you can't separate them, avoid the abametapir and ask your care team for guidance. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sonidegib and Abametapir 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 Sonidegib and Abametapir interaction managed?
This interaction is manageable, mainly by timing. Because abametapir can slow the breakdown of sonidegib for a while after use, the documented guidance is to keep them apart. Avoid starting sonidegib within 2 weeks after applying abametapir lice treatment. If that spacing is not feasible, the alternative is to avoid using abametapir. Keep taking sonidegib as prescribed unless your care team tells… 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 Sonidegib or Abametapir 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 Sonidegib
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