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== '''What Is Lonafarnib?''' ==
== Lonafarnib ==


Lonafarnib (ZOKINVY) is a prescription medicine used to:
[[File:Lonafarnib.svg|thumb|right|Chemical structure of Lonafarnib]]
* lower the risk of death in adults and children 12 months of age or older with Hutchinson-Gilford Progeria Syndrome (HGPS), who have a certain body surface area.
* treat adults and children 12 months of age or older with certain types of Progeroid Laminopathies, who have a certain body surface area.


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'''Lonafarnib''' is a farnesyltransferase inhibitor (FTI) that has been studied for its potential use in treating various medical conditions, including [[progeria]] and certain types of [[cancer]]. It works by inhibiting the enzyme farnesyltransferase, which is involved in the post-translational modification of proteins through the addition of a farnesyl group. This modification is crucial for the proper functioning of several proteins, including those involved in cell signaling and growth.
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== '''What are the uses of this medicine?''' ==
== Mechanism of Action ==


This medicine is indicated in patients 12 months of age and older with a body surface area (BSA) of 0.39 m2 and above:
Lonafarnib targets the enzyme [[farnesyltransferase]], which catalyzes the attachment of a farnesyl group to proteins bearing a CaaX motif at their C-terminus. This process, known as farnesylation, is essential for the proper localization and function of these proteins. By inhibiting farnesyltransferase, lonafarnib prevents the farnesylation of proteins such as [[Ras]], which are involved in cell growth and division. This inhibition can disrupt the signaling pathways that lead to uncontrolled cell proliferation, making lonafarnib a potential therapeutic agent in cancer treatment.
* To reduce the risk of mortality in Hutchinson-Gilford Progeria Syndrome (HGPS)


For the treatment of processing-deficient Progeroid Laminopathies with either:
== Clinical Applications ==
* Heterozygous LMNA mutation with progerin-like protein accumulation
* Homozygous or compound heterozygous ZMPSTE24 mutations


== '''How does this medicine work?''' ==
=== Progeria ===


* Lonafarnib inhibits farnesyl transferase '''to prevent farnesylation and subsequent accumulation of progerin and progerin-like proteins in the inner nuclear membrane.
Lonafarnib has been investigated as a treatment for [[Hutchinson-Gilford progeria syndrome]] (HGPS), a rare genetic disorder characterized by accelerated aging in children. In HGPS, a mutant form of the protein [[lamin A]], known as progerin, accumulates due to improper farnesylation. Lonafarnib helps reduce the accumulation of progerin by inhibiting its farnesylation, thereby ameliorating some of the symptoms associated with the disease.
'''
== '''Who Should Not Use this medicine ?''' ==


Do not take ZOKINVY if you are taking:
=== Cancer ===
* a strong or moderate CYP3A inhibitor or inducer
* [[midazolam]]
* [[lovastatin]] or [[simvastatin]] or [[atorvastatin]]


== '''Is this medicine FDA approved?''' ==
In oncology, lonafarnib has been studied for its potential to treat various types of cancer, including [[pancreatic cancer]], [[colorectal cancer]], and [[leukemia]]. By inhibiting the farnesylation of oncogenic proteins such as Ras, lonafarnib may interfere with cancer cell growth and survival. However, its efficacy as a standalone treatment has been limited, and it is often studied in combination with other anticancer agents.


* It was approved for use in the United States in 2020.
== Side Effects ==


== '''How should this medicine be used?''' ==
The use of lonafarnib can be associated with several side effects, including gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Other potential side effects include fatigue, anemia, and liver enzyme abnormalities. The severity of these side effects can vary depending on the dosage and duration of treatment.


* Start at 115 mg/m2 twice daily with morning and evening meals
== Research and Development ==
* After 4 months, increase to 150 mg/m2 twice daily
* Round all total daily doses to nearest 25 mg increment
* Swallow capsules whole
* If unable to swallow capsules, mix contents with Ora Blend SF®, Ora-Plus®, orange juice, or applesauce


== '''What are the  dosage forms and brand names of this medicine?''' ==
Lonafarnib continues to be the subject of clinical research, with ongoing studies exploring its efficacy and safety in various therapeutic contexts. Researchers are particularly interested in its potential use in combination therapies for cancer and its long-term effects in treating progeria.


This medicine is available in fallowing doasage form:
== Related Pages ==
* Available as 50 mg and 75 mg Capsules


This medicine is available in fallowing brand namesː
* [[Farnesyltransferase]]
* '''ZOKINVY'''
* [[Progeria]]
* [[Cancer treatment]]
* [[Ras protein]]


=='''What side effects can this medication cause?'''==
[[Category:Antineoplastic drugs]]
 
[[Category:Enzyme inhibitors]]
Common possible side effects of this medicine include:
[[Category:Progeria treatments]]
* vomiting
* diarrhea
* infection
* nausea
* decreased appetite
* tiredness
* upper respiratory tract infection
* stomach-area (abdominal) pain
* muscle and joint (musculoskeletal) pain
* electrolyte abnormalities
* decreased weight
* headache
* myelosuppression
* increased liver enzyme blood test results
* decreased blood bicarbonate
* cough
* hypertension
 
ZOKINVY may cause serious side effects, including:
* Severe kidney problems
* Eye problems
 
==''' What special precautions should I follow?''' ==
 
* Advise females of reproductive potential of the risk to a fetus and to use effective contraception.
* Monitor for changes in electrolytes, complete blood counts, and liver enzymes.
* Monitor renal function at regular intervals
* Perform ophthalmological evaluation at regular intervals and at the onset of any new visual changes.
* Advise females and males of reproductive potential about Impaired Fertility.
 
== '''What to do in case of emergency/overdose?''' ==
 
== '''Can this medicine be used in pregnancy?''' ==
 
* There are no human data on ZOKINVY use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes.
* Advise pregnant women of the risk to a fetus.
 
=='''Can this medicine be used in children?'''==
 
* The safety and effectiveness of ZOKINVY for the treatment of HGPS and processing-deficient Progeroid Laminopathies (with either heterozygous LMNA mutation with progerin-like protein accumulation or homozygous or compound heterozygous ZMPSTE24 mutations) have been established in pediatric patients 12 months of age and older.
* The safety and effectiveness of ZOKINVY in pediatric patients less than 12 months of age have not been established.
 
== '''What should I know about storage and disposal of this medication?''' ==
 
* Store at room temperature between 68°F to 77°F (20°C to 25°C)
 
{{Portal bar | Medicine}}
 
[[Category:Benzocycloheptapyridines]]
[[Category:Breakthrough therapy]]
[[Category:Chloroarenes]]
[[Category:Farnesyltransferase inhibitors]]
[[Category:Organobromides]]
[[Category:Orphan drugs]]
[[Category:Piperidines]]
[[Category:Ureas]]
{{coststubd}}

Latest revision as of 03:57, 13 February 2025

Lonafarnib[edit]

Chemical structure of Lonafarnib

Lonafarnib is a farnesyltransferase inhibitor (FTI) that has been studied for its potential use in treating various medical conditions, including progeria and certain types of cancer. It works by inhibiting the enzyme farnesyltransferase, which is involved in the post-translational modification of proteins through the addition of a farnesyl group. This modification is crucial for the proper functioning of several proteins, including those involved in cell signaling and growth.

Mechanism of Action[edit]

Lonafarnib targets the enzyme farnesyltransferase, which catalyzes the attachment of a farnesyl group to proteins bearing a CaaX motif at their C-terminus. This process, known as farnesylation, is essential for the proper localization and function of these proteins. By inhibiting farnesyltransferase, lonafarnib prevents the farnesylation of proteins such as Ras, which are involved in cell growth and division. This inhibition can disrupt the signaling pathways that lead to uncontrolled cell proliferation, making lonafarnib a potential therapeutic agent in cancer treatment.

Clinical Applications[edit]

Progeria[edit]

Lonafarnib has been investigated as a treatment for Hutchinson-Gilford progeria syndrome (HGPS), a rare genetic disorder characterized by accelerated aging in children. In HGPS, a mutant form of the protein lamin A, known as progerin, accumulates due to improper farnesylation. Lonafarnib helps reduce the accumulation of progerin by inhibiting its farnesylation, thereby ameliorating some of the symptoms associated with the disease.

Cancer[edit]

In oncology, lonafarnib has been studied for its potential to treat various types of cancer, including pancreatic cancer, colorectal cancer, and leukemia. By inhibiting the farnesylation of oncogenic proteins such as Ras, lonafarnib may interfere with cancer cell growth and survival. However, its efficacy as a standalone treatment has been limited, and it is often studied in combination with other anticancer agents.

Side Effects[edit]

The use of lonafarnib can be associated with several side effects, including gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Other potential side effects include fatigue, anemia, and liver enzyme abnormalities. The severity of these side effects can vary depending on the dosage and duration of treatment.

Research and Development[edit]

Lonafarnib continues to be the subject of clinical research, with ongoing studies exploring its efficacy and safety in various therapeutic contexts. Researchers are particularly interested in its potential use in combination therapies for cancer and its long-term effects in treating progeria.

Related Pages[edit]