Drug interactions
Lorlatinib + Mitotane
Severity: Contraindicated
Lorlatinib and Mitotane: contraindicated 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
Mitotane is a strong CYP3A4 inducer with a very long half-life, and can markedly lower lorlatinib exposure. This may lead to loss of efficacy and hepatotoxicity.
What this interaction means in plain words
Lorlatinib and Mitotane are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Lorlatinib belongs to Oncology; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4 and increases lorlatinib metabolism.
What to do
Avoid the combination; because mitotane persists for weeks to months, choose an alternative to lorlatinib or other therapy.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
- Aripiprazole + Mitotane Major
Frequently asked questions
Can I take Lorlatinib with Mitotane?
MediHelp rates the interaction as contraindicated. Lorlatinib and Mitotane are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Mitotane is a strong CYP3A4 inducer with a very long half-life, and can markedly lower lorlatinib exposure. This may lead to loss of efficacy and hepatotoxicity.
How serious is the interaction between Lorlatinib and Mitotane?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; because mitotane persists for weeks to months, choose an alternative to lorlatinib or other therapy.
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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