Drug interactions
Elbasvir / grazoprevir + Lorlatinib
Severity: Major
Elbasvir / grazoprevir 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
Lorlatinib induces CYP3A and may substantially reduce elbasvir and grazoprevir concentrations, risking hepatitis C treatment failure. Labeling for the antiviral combination advises against CYP3A inducers.
What this interaction means in plain words
Elbasvir / grazoprevir 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.
Why it happens
Lorlatinib induces CYP3A4 (and possibly P-gp), increasing clearance of elbasvir and grazoprevir.
What to do
Avoid the combination; defer HCV therapy or choose another regimen. If unavoidable, monitor HCV RNA.
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
Frequently asked questions
Can I take Elbasvir / grazoprevir with Lorlatinib?
MediHelp rates the interaction as major. Elbasvir / grazoprevir 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. Lorlatinib induces CYP3A and may substantially reduce elbasvir and grazoprevir concentrations, risking hepatitis C treatment failure. Labeling for the antiviral combination advises against CYP3A inducers.
How serious is the interaction between Elbasvir / grazoprevir 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; defer HCV therapy or choose another regimen. If unavoidable, monitor HCV RNA.
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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