Drug interactions
Atazanavir + Lorlatinib
Severity: Major
Atazanavir and Lorlatinib: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir is a strong CYP3A4 inhibitor and can raise lorlatinib levels, increasing the risk of hyperlipidaemia, CNS effects and PR prolongation. Lorlatinib may in turn lower atazanavir levels through CYP3A induction, risking antiviral failure.
What this interaction means in plain words
Atazanavir and Lorlatinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Lorlatinib belongs to Oncology.
Why it happens
Atazanavir inhibits CYP3A4, raising lorlatinib exposure, while lorlatinib induces CYP3A4, lowering atazanavir exposure.
What to do
Avoid the combination and choose an alternative antiretroviral. If it is unavoidable, reduce the lorlatinib dose per labeling and monitor HIV viral load, ECG and lipids.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Lorlatinib
- Amobarbital + Lorlatinib Contraindicated
- Apalutamide + Lorlatinib Contraindicated
- Butabarbital + Lorlatinib Contraindicated
- Carbamazepine + Lorlatinib Contraindicated
- Enzalutamide + Lorlatinib Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Lorlatinib?
MediHelp rates the interaction as major. Atazanavir and Lorlatinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir is a strong CYP3A4 inhibitor and can raise lorlatinib levels, increasing the risk of hyperlipidaemia, CNS effects and PR prolongation. Lorlatinib may in turn lower atazanavir levels through CYP3A induction, risking antiviral failure.
How serious is the interaction between Atazanavir and Lorlatinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and choose an alternative antiretroviral. If it is unavoidable, reduce the lorlatinib dose per labeling and monitor HIV viral load, ECG and lipids.
What other medicines interact with Lorlatinib?
MediHelp also lists interactions of Lorlatinib with, for example, Amobarbital, Apalutamide, Butabarbital. The full list is on the Lorlatinib page.
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