Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Lorlatinib
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df 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 lower elvitegravir and cobicistat exposure, risking loss of viral suppression and resistance. Cobicistat, a strong CYP3A inhibitor, can also raise lorlatinib levels and its toxicity.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df 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 reducing elvitegravir/cobicistat, while cobicistat inhibits CYP3A4 and raises lorlatinib.
What to do
Avoid the combination and use an antiretroviral regimen without CYP3A dependence. If unavoidable, monitor HIV viral load, lipids and liver tests.
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 Elvitegravir / cobicistat / emtricitabine / tenofovir df with Lorlatinib?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df 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 lower elvitegravir and cobicistat exposure, risking loss of viral suppression and resistance. Cobicistat, a strong CYP3A inhibitor, can also raise lorlatinib levels and its toxicity.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df 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 use an antiretroviral regimen without CYP3A dependence. If unavoidable, monitor HIV viral load, lipids and liver tests.
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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