Drug & supplement interaction

Ostarine + Lonafarnib

Lonafarnib brand name: Zokinvy.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Lonafarnib falls into 2 drug categories that Ostarine can interact with; the most serious is rated minor. Theoretically, concomitant use of ostarine with CYP3A4 inhibitors could increase the effects and adverse effects of ostarine, although this is unlikely to be clinically significant.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ostarine and Lonafarnib

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Ostarine interacts with whole categories of medication. Lonafarnib falls into 2 of those categories, so it can interact with Ostarine in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

1 of 2

Why this applies to Lonafarnib

Lonafarnib falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Ostarine interacts with.

Theoretically, concomitant use of ostarine with CYP3A4 inhibitors could increase the effects and adverse effects of ostarine, although this is unlikely to be clinically significant.
Ostarine is partially metabolized by CYP3A4. However, clinical research shows that taking itraconazole, a potent inhibitor of CYP3A4, had minimal effects on the levels of ostarine in the body.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the situation with these two. Lonafarnib (Zokinvy) is a medication that blocks an enzyme in your body called CYP3A4. Ostarine happens to get partially broken down by that same enzyme. So in theory, taking lonafarnib could slow the clearance of ostarine a little, letting more of it build up and raising the chance of ostarine's side effects, which can include liver injury, hormone disruption, and cardiovascular strain.

That said, the real-world evidence here is reassuring. When researchers paired ostarine with itraconazole, a very strong CYP3A4 blocker, the ostarine levels barely budged. So this interaction is rated minor and unlikely to matter much. My bigger concern is that ostarine itself is an unapproved, banned substance tied to liver harm. Please talk with your doctor before combining it with any prescription.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Coss CC, Jones A, Dalton JT. Pharmacokinetic drug interactions of the selective androgen receptor modulator GTx-024 (enobosarm) with itraconazole, rifampin, probenecid, celecoxib and rosuvastatin. Invest New Drugs 2016;34(4):458-67. PubMed
Minor

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 2

Lonafarnib also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, ostarine might increase levels of drugs metabolized by CYP2C9, although clinical research suggests this is not clinically relevant.
Although in vitro research suggests that ostarine inhibits CYP2C9, more robust clinical research shows that ostarine does not significantly affect CYP2C9.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Zokinvy (lonafarnib). On paper, Ostarine was thought to block an enzyme called CYP2C9, which helps your body process certain medications. If that blocking really happened, lonafarnib could build up and you might see more of its usual side effects, like nausea, vomiting, diarrhea, poor appetite, or fatigue. Lonafarnib is also a drug we watch closely, so big swings in its level aren't something to shrug off.

But the better human studies don't back this up. The enzyme-blocking effect only showed up in lab dish testing, and real clinical research suggests Ostarine doesn't meaningfully affect CYP2C9. So this particular concern is mostly theoretical. The bigger issue is that Ostarine itself is an unapproved SARM tied to liver injury, so please run it by your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Coss CC, Jones A, Dalton JT. Pharmacokinetic drug interactions of the selective androgen receptor modulator GTx-024 (enobosarm) with itraconazole, rifampin, probenecid, celecoxib and rosuvastatin. Invest New Drugs 2016;34(4):458-67. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ostarine Also Interacts With Other Medications

Ostarine has 440 moderate, 170 minor known drug interactions in our database — the Lonafarnib one above is among them. If you take anything else, check it against the full list below.

Moderate 440 Minor 170 No known interaction 2,220 (incl. Lonafarnib)
Taking anything else?

Check Another of Your Medications Against Ostarine

Covers the 2,830 medications we’ve checked against Ostarine. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Lonafarnib

This page covers Ostarine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lonafarnib page lists 160 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 5 major · 115 moderate · 40 minor.

From our pharmacist’s overview on the Lonafarnib page

“If you or your child takes lonafarnib (Zokinvy) for progeria, treat supplements with real caution. Most of the 160 flagged ingredients cross paths with the CYP3A4 enzyme, the same one that handles lonafarnib, so the traffic runs both ways.”

Reviewed by 2 · Jul 18, 2026

Open the Lonafarnib interaction page

One more smart check

Taking Ostarine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 33 real supplement products containing Ostarine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ostarine. Your product may carry other ingredients that interact with Lonafarnib too, on top of Ostarine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ostarine and Lonafarnib Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ostarine
Steady interest

#980 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Lonafarnib
Top half

#1,349 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ostarine

What is Ostarine?

  • Muscle building
  • Athletic performance
  • Fat loss / body recomposition
  • Bodybuilding cycles

Ostarine (also called MK-2866 or enobosarm) is an experimental, unapproved drug known as a SARM (selective androgen receptor modulator), not a true dietary supplement. It is not approved by the FDA, is banned in sports, and has been linked to liver injury and other serious harms, so it is not recommended for general use.

Read the full Ostarine monograph & all interactions
Medication

About Lonafarnib

What Is Lonafarnib Used For?

Brand name: Zokinvy

Zokinvy (lonafarnib) is approved for patients 12 months of age and older who have a body surface area of 0.39 m² or above. It is used to reduce the risk of mortality in Hutchinson-Gilford Progeria Syndrome (HGPS) — a rare, severe premature-aging disorder.

Zokinvy is also used to treat processing-deficient Progeroid Laminopathies — a related group of rare genetic conditions — specifically those caused by a heterozygous LMNA mutation with progerin-like protein buildup, or by homozygous or compound heterozygous ZMPSTE24 mutations. It is not indicated for other Progeroid Syndromes or processing-proficient Progeroid Laminopathies.

See full Lonafarnib drug information
Keep checking

Other Drugs & Ostarine

Browse every other medication we’ve checked against Ostarine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
440Moderate
170Minor
2,219No known interaction
440 Moderate 170 Minor 2,219 No interaction
Moderate

440 interactions

Showing 60 of 440 moderate interactions — see all 440 on the Ostarine page.

Minor

170 interactions

Showing 60 of 170 minor interactions — see all 170 on the Ostarine page.

No interaction 2,219 drugs checked — show the list

We also checked Ostarine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,219 medications checked with no known interaction — see the full Ostarine list.

See the full Ostarine interactions page
See every supplement checked against Lonafarnib, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Ostarine monograph › Uses, safety, and every drug interaction in one place Lonafarnib supplement interactions › Every supplement checked against Lonafarnib, ranked by severity Lonafarnib drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Ostarine and Lonafarnib Together: Common Questions

Can you take Ostarine with Lonafarnib?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Ostarine and Lonafarnib?
Lonafarnib belongs to more than one drug category, and Ostarine interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Ostarine and Lonafarnib interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Lonafarnib and Ostarine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.