Drug interactions
Ethinyl estradiol-levonorgestrel + Lorlatinib
Severity: Major
Ethinyl estradiol-levonorgestrel and Lorlatinib: major interaction.
Last updated Sources: UK SmPC
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 CYP3A4 inducer and may reduce levels of hormonal contraceptives. This can lead to contraceptive failure. Lorlatinib also carries embryo-fetal risk, making reliable contraception important.
What this interaction means in plain words
Ethinyl estradiol-levonorgestrel 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-levonorgestrel belongs to Endocrine; Lorlatinib belongs to Oncology.
Why it happens
Induction of CYP3A4 increases the metabolic clearance of the contraceptive hormones.
What to do
Avoid relying on hormonal contraceptives; use a non-hormonal method such as a copper IUD or consistent barrier method during therapy and after its discontinuation as per labeling.
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
- Lorviqua 100 mg film coated tablets - SmPC sections 4.3/4.5 (class statement: hormonal contraceptives; "including but not limited to alfentanil, ciclosporin, dihydroergotamine, ergotamine, fentanyl, hormonal contraceptives, pimozide, quinidine, sirolimus and tacro") — electronic medicines compendium (UK SmPC)
Other interactions of Ethinyl estradiol-levonorgestrel
- Ethinyl estradiol-levonorgestrel + Fezolinetant Contraindicated
- Ethinyl estradiol-levonorgestrel + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-levonorgestrel + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-levonorgestrel Major
- Amobarbital + Ethinyl estradiol-levonorgestrel Major
- Anastrozole + Ethinyl estradiol-levonorgestrel 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-levonorgestrel with Lorlatinib?
MediHelp rates the interaction as major. Ethinyl estradiol-levonorgestrel 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 CYP3A4 inducer and may reduce levels of hormonal contraceptives. This can lead to contraceptive failure. Lorlatinib also carries embryo-fetal risk, making reliable contraception important.
How serious is the interaction between Ethinyl estradiol-levonorgestrel 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 relying on hormonal contraceptives; use a non-hormonal method such as a copper IUD or consistent barrier method during therapy and after its discontinuation as per labeling.
What other medicines interact with Ethinyl estradiol-levonorgestrel?
MediHelp also lists interactions of Ethinyl estradiol-levonorgestrel with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Tranexamic acid. The full list is on the Ethinyl estradiol-levonorgestrel page.
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