Drug interactions
Fentanyl intranasal + Lorlatinib
Severity: Major
Fentanyl intranasal 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 may lower fentanyl concentrations, causing reduced analgesia or withdrawal in opioid-dependent patients. If lorlatinib is stopped, fentanyl levels can rise, increasing the risk of respiratory depression.
What this interaction means in plain words
Fentanyl intranasal 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, increasing the metabolism of fentanyl.
What to do
Monitor pain control and withdrawal and titrate fentanyl as needed. After stopping lorlatinib, watch for sedation and respiratory depression and reduce the dose.
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 Fentanyl intranasal with Lorlatinib?
MediHelp rates the interaction as major. Fentanyl intranasal 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 may lower fentanyl concentrations, causing reduced analgesia or withdrawal in opioid-dependent patients. If lorlatinib is stopped, fentanyl levels can rise, increasing the risk of respiratory depression.
How serious is the interaction between Fentanyl intranasal 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: Monitor pain control and withdrawal and titrate fentanyl as needed. After stopping lorlatinib, watch for sedation and respiratory depression and reduce the dose.
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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