Drug interactions
Itraconazole + Lorlatinib
Severity: Major
Itraconazole 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
Itraconazole increases lorlatinib exposure, which may worsen CNS effects, hyperlipidemia, and PR interval prolongation. Lorlatinib is itself a CYP3A inducer and may lower itraconazole concentrations, risking loss of antifungal efficacy.
What this interaction means in plain words
Itraconazole 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.
Itraconazole belongs to Anti Fungals; Lorlatinib belongs to Oncology.
Why it happens
Itraconazole strongly inhibits CYP3A4, which metabolizes lorlatinib, while lorlatinib induces CYP3A and may reduce itraconazole levels.
What to do
Avoid concurrent use and consider a non-CYP3A-inhibiting antifungal. If unavoidable, reduce the lorlatinib dose per labeling, monitor ECG and lipids, and check antifungal response or itraconazole levels.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
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 Itraconazole with Lorlatinib?
MediHelp rates the interaction as major. Itraconazole 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. Itraconazole increases lorlatinib exposure, which may worsen CNS effects, hyperlipidemia, and PR interval prolongation. Lorlatinib is itself a CYP3A inducer and may lower itraconazole concentrations, risking loss of antifungal efficacy.
How serious is the interaction between Itraconazole 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 concurrent use and consider a non-CYP3A-inhibiting antifungal. If unavoidable, reduce the lorlatinib dose per labeling, monitor ECG and lipids, and check antifungal response or itraconazole levels.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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