Drug interactions
Lorlatinib + Modafinil
Severity: Major
Lorlatinib and Modafinil: 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
Modafinil is a weak to moderate CYP3A4 inducer and may lower lorlatinib concentrations, reducing antitumor efficacy. Lorlatinib labeling warns that CYP3A inducers can increase hepatotoxicity risk, notably with strong inducers.
What this interaction means in plain words
Lorlatinib and Modafinil 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; Modafinil belongs to Central Nervous System.
Why it happens
Modafinil induces CYP3A4, increasing the metabolism of lorlatinib, a CYP3A4 substrate.
What to do
Avoid the combination where possible and choose a non-inducing alternative. If it cannot be avoided, monitor liver enzymes, bilirubin and tumor response.
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 Modafinil
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 Modafinil?
MediHelp rates the interaction as major. Lorlatinib and Modafinil 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. Modafinil is a weak to moderate CYP3A4 inducer and may lower lorlatinib concentrations, reducing antitumor efficacy. Lorlatinib labeling warns that CYP3A inducers can increase hepatotoxicity risk, notably with strong inducers.
How serious is the interaction between Lorlatinib and Modafinil?
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 where possible and choose a non-inducing alternative. If it cannot be avoided, monitor liver enzymes, bilirubin and tumor response.
What other medicines interact with Modafinil?
MediHelp also lists interactions of Modafinil with, for example, Lenacapavir, Leniolisib, Lumateperone. The full list is on the Modafinil page.
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