Drug interactions
Lorlatinib + Mifepristone
Severity: Major
Lorlatinib and Mifepristone: 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
Mifepristone inhibits CYP3A4 and may increase lorlatinib exposure, raising the risk of hyperlipidemia, CNS effects, and PR interval prolongation. Lorlatinib is itself a CYP3A inducer and may lower mifepristone concentrations, reducing its efficacy.
What this interaction means in plain words
Lorlatinib and Mifepristone 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; Mifepristone belongs to Endocrine.
Why it happens
Mifepristone inhibits CYP3A4 metabolism of lorlatinib, while lorlatinib induces CYP3A and may reduce mifepristone exposure.
What to do
Avoid the combination. If it cannot be avoided, reduce the lorlatinib dose 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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone 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 Lorlatinib with Mifepristone?
MediHelp rates the interaction as major. Lorlatinib and Mifepristone 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. Mifepristone inhibits CYP3A4 and may increase lorlatinib exposure, raising the risk of hyperlipidemia, CNS effects, and PR interval prolongation. Lorlatinib is itself a CYP3A inducer and may lower mifepristone concentrations, reducing its efficacy.
How serious is the interaction between Lorlatinib and Mifepristone?
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 it cannot be avoided, reduce the lorlatinib dose per labeling for strong CYP3A inhibitors and monitor lipids, ECG and CNS effects.
What other medicines interact with Mifepristone?
MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.
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