Drug interactions
Lorlatinib + Midostaurin
Severity: Major
Lorlatinib and Midostaurin: 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
Midostaurin and its active metabolites depend on CYP3A4, and inducers markedly lower exposure. Lorlatinib may reduce midostaurin efficacy in AML or mastocytosis.
What this interaction means in plain words
Lorlatinib and Midostaurin 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 belongs to Oncology; Midostaurin belongs to Oncology.
Why it happens
Lorlatinib induces CYP3A4, increasing midostaurin metabolism.
What to do
Consider an alternative to lorlatinib where possible. If combined, monitor leukemia response closely.
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 Midostaurin
Frequently asked questions
Can I take Lorlatinib with Midostaurin?
MediHelp rates the interaction as major. Lorlatinib and Midostaurin 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. Midostaurin and its active metabolites depend on CYP3A4, and inducers markedly lower exposure. Lorlatinib may reduce midostaurin efficacy in AML or mastocytosis.
How serious is the interaction between Lorlatinib and Midostaurin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an alternative to lorlatinib where possible. If combined, monitor leukemia response closely.
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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