Drug interactions
Lorlatinib + Midazolam intranasal
Severity: Moderate
Lorlatinib and Midazolam intranasal: moderate 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 induces CYP3A4, so the expected effect is lower midazolam exposure and possibly a weaker seizure-rescue effect. Lorlatinib is a net CYP3A inducer, and midazolam is a sensitive substrate.
What this interaction means in plain words
Lorlatinib and Midazolam intranasal can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Lorlatinib induces CYP3A4, increasing midazolam clearance; its effect may differ between oral and nasal routes but is likely reduced exposure.
What to do
Monitor for reduced seizure control or sedation efficacy and use a higher dose or alternative rescue agent if needed. Reassess if lorlatinib is stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Lorlatinib with Midazolam intranasal?
MediHelp rates the interaction as moderate. Lorlatinib and Midazolam intranasal can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lorlatinib induces CYP3A4, so the expected effect is lower midazolam exposure and possibly a weaker seizure-rescue effect. Lorlatinib is a net CYP3A inducer, and midazolam is a sensitive substrate.
How serious is the interaction between Lorlatinib and Midazolam intranasal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced seizure control or sedation efficacy and use a higher dose or alternative rescue agent if needed. Reassess if lorlatinib is stopped.
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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