Drug interactions
Idelalisib + Lorlatinib
Severity: Major
Idelalisib 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
Idelalisib is a strong CYP3A4 inhibitor and can substantially raise lorlatinib exposure, increasing hyperlipidemia, CNS effects and PR prolongation. Lorlatinib in turn may induce CYP3A4 and lower idelalisib exposure, potentially reducing efficacy.
What this interaction means in plain words
Idelalisib 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.
Idelalisib belongs to Oncology; Lorlatinib belongs to Oncology.
Why it happens
Idelalisib inhibits CYP3A4, and lorlatinib induces CYP3A4, affecting both drugs.
What to do
Avoid the combination if possible. If unavoidable, reduce lorlatinib dose as per labeling for strong CYP3A inhibitors and monitor lipids, ECG and CNS effects.
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
Other interactions of Idelalisib
- Alfuzosin + Idelalisib Contraindicated
- Cisapride + Idelalisib Contraindicated
- Dihydroergotamine + Idelalisib Contraindicated
- Dronedarone + Idelalisib Contraindicated
- Eletriptan + Idelalisib Contraindicated
- Eplerenone + Idelalisib Contraindicated
Frequently asked questions
Can I take Idelalisib with Lorlatinib?
MediHelp rates the interaction as major. Idelalisib 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. Idelalisib is a strong CYP3A4 inhibitor and can substantially raise lorlatinib exposure, increasing hyperlipidemia, CNS effects and PR prolongation. Lorlatinib in turn may induce CYP3A4 and lower idelalisib exposure, potentially reducing efficacy.
How serious is the interaction between Idelalisib 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 if possible. If unavoidable, reduce lorlatinib dose as per labeling for strong CYP3A inhibitors and monitor lipids, ECG and CNS effects.
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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