Drug interactions
Ethinyl estradiol-drospirenone + Lorlatinib
Severity: Major
Ethinyl estradiol-drospirenone 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
Lorlatinib is a moderate CYP3A inducer and may lower hormonal contraceptive concentrations, reducing contraceptive efficacy. Lorlatinib labeling advises that hormonal contraceptives may not be effective and also warns of hepatotoxicity with strong inducers and certain combinations.
What this interaction means in plain words
Ethinyl estradiol-drospirenone 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.
Ethinyl estradiol-drospirenone belongs to Endocrine; Lorlatinib belongs to Oncology.
Why it happens
Induction of CYP3A4 by lorlatinib increases the metabolism of ethinyl estradiol and drospirenone.
What to do
Use a non-hormonal contraceptive method (such as a copper IUD or condoms) during lorlatinib therapy and for the period advised in labeling after stopping. Do not rely on the combined pill alone.
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 Ethinyl estradiol-drospirenone
- Ethinyl estradiol-drospirenone + Fezolinetant Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-drospirenone Major
- Amobarbital + Ethinyl estradiol-drospirenone Major
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 Ethinyl estradiol-drospirenone with Lorlatinib?
MediHelp rates the interaction as major. Ethinyl estradiol-drospirenone 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 is a moderate CYP3A inducer and may lower hormonal contraceptive concentrations, reducing contraceptive efficacy. Lorlatinib labeling advises that hormonal contraceptives may not be effective and also warns of hepatotoxicity with strong inducers and certain combinations.
How serious is the interaction between Ethinyl estradiol-drospirenone 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: Use a non-hormonal contraceptive method (such as a copper IUD or condoms) during lorlatinib therapy and for the period advised in labeling after stopping. Do not rely on the combined pill alone.
What other medicines interact with Ethinyl estradiol-drospirenone?
MediHelp also lists interactions of Ethinyl estradiol-drospirenone with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Ethinyl estradiol-drospirenone page.
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