Drug interactions
Indinavir + Lorlatinib
Severity: Major
Indinavir 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
Indinavir is a strong CYP3A4 inhibitor and can markedly increase lorlatinib levels, with greater risk of lipid elevation, neurocognitive effects and conduction abnormalities. Lorlatinib may also lower indinavir levels via CYP3A4 induction, risking loss of antiviral control.
What this interaction means in plain words
Indinavir 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
Indinavir inhibits CYP3A4 while lorlatinib induces CYP3A4.
What to do
Avoid if possible and choose another antiretroviral. If coadministered, reduce lorlatinib dose per labeling and monitor ECG, lipids and HIV viral load.
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 Indinavir with Lorlatinib?
MediHelp rates the interaction as major. Indinavir 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. Indinavir is a strong CYP3A4 inhibitor and can markedly increase lorlatinib levels, with greater risk of lipid elevation, neurocognitive effects and conduction abnormalities. Lorlatinib may also lower indinavir levels via CYP3A4 induction, risking loss of antiviral control.
How serious is the interaction between Indinavir 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 if possible and choose another antiretroviral. If coadministered, reduce lorlatinib dose per labeling and monitor ECG, lipids and HIV viral load.
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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