Drug interactions
Cenobamate + Lorlatinib
Severity: Major
Cenobamate and Lorlatinib: major interaction.
Last updated
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
Cenobamate induces CYP3A4 and may substantially lower lorlatinib exposure. Strong inducers of this kind can cause loss of lorlatinib efficacy, and lorlatinib itself can raise liver enzymes when exposure is altered or combined with inducers.
What this interaction means in plain words
Cenobamate 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.
Cenobamate belongs to Central Nervous System; Lorlatinib belongs to Oncology.
Why it happens
Cenobamate induces CYP3A4, accelerating lorlatinib clearance.
What to do
Avoid the combination if an alternative antiseizure drug is possible; otherwise monitor tumor response and liver enzymes closely.
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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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 Cenobamate
Frequently asked questions
Can I take Cenobamate with Lorlatinib?
MediHelp rates the interaction as major. Cenobamate 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. Cenobamate induces CYP3A4 and may substantially lower lorlatinib exposure. Strong inducers of this kind can cause loss of lorlatinib efficacy, and lorlatinib itself can raise liver enzymes when exposure is altered or combined with inducers.
How serious is the interaction between Cenobamate 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 if an alternative antiseizure drug is possible; otherwise monitor tumor response and liver enzymes closely.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
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