Drug interactions
Lorlatinib + Nefazodone
Severity: Major
Lorlatinib and Nefazodone: major interaction.
Last updated Sources: US FDA label
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
Nefazodone is a strong CYP3A4 inhibitor and can increase lorlatinib exposure, raising risk of lipid elevation, CNS effects and PR prolongation. Lorlatinib may lower nefazodone levels through CYP3A4 induction.
What this interaction means in plain words
Lorlatinib and Nefazodone 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.
Why it happens
Nefazodone inhibits CYP3A4, while lorlatinib induces CYP3A4.
What to do
Avoid and choose another antidepressant. If unavoidable, reduce lorlatinib dose per labeling and monitor ECG and mood or cognition.
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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References
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 Nefazodone?
MediHelp rates the interaction as major. Lorlatinib and Nefazodone 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. Nefazodone is a strong CYP3A4 inhibitor and can increase lorlatinib exposure, raising risk of lipid elevation, CNS effects and PR prolongation. Lorlatinib may lower nefazodone levels through CYP3A4 induction.
How serious is the interaction between Lorlatinib and Nefazodone?
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 and choose another antidepressant. If unavoidable, reduce lorlatinib dose per labeling and monitor ECG and mood or cognition.
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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