Drug interactions
Darunavir + Lorlatinib
Severity: Major
Darunavir 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
Darunavir, usually boosted with ritonavir or cobicistat, strongly inhibits CYP3A and can increase lorlatinib exposure and its toxicities. Lorlatinib may in turn lower darunavir concentrations, risking reduced antiviral activity.
What this interaction means in plain words
Darunavir 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.
Darunavir belongs to Anti Virals; Lorlatinib belongs to Oncology.
Why it happens
Boosted darunavir inhibits CYP3A4 reducing lorlatinib clearance, while lorlatinib induces CYP3A4 and may lower darunavir levels.
What to do
Avoid the combination. If unavoidable, reduce lorlatinib dose per labeling and monitor lipids, liver tests, CNS effects and HIV viral load.
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 Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Lorlatinib?
MediHelp rates the interaction as major. Darunavir 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. Darunavir, usually boosted with ritonavir or cobicistat, strongly inhibits CYP3A and can increase lorlatinib exposure and its toxicities. Lorlatinib may in turn lower darunavir concentrations, risking reduced antiviral activity.
How serious is the interaction between Darunavir 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 unavoidable, reduce lorlatinib dose per labeling and monitor lipids, liver tests, CNS effects and HIV viral load.
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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