Drug interactions
Lorlatinib + Nevirapine
Severity: Major
Lorlatinib and Nevirapine: major interaction.
Last updated Sources: UK SmPC
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
Lorlatinib is a moderate CYP3A inducer and may lower nevirapine concentrations, risking virologic failure. Nevirapine, an inducer itself, may also lower lorlatinib exposure, and both drugs carry hepatotoxicity risk. Lorlatinib labeling reports hepatotoxicity with strong CYP3A inducers.
What this interaction means in plain words
Lorlatinib and Nevirapine 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; Nevirapine belongs to Anti Virals.
Why it happens
Mutual CYP3A4 induction alters exposure of both drugs, and their hepatotoxic effects may be additive.
What to do
Avoid the combination where possible and choose an alternative antiretroviral. If used together, monitor liver enzymes frequently and HIV viral load.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
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 Nevirapine?
MediHelp rates the interaction as major. Lorlatinib and Nevirapine 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 is a moderate CYP3A inducer and may lower nevirapine concentrations, risking virologic failure. Nevirapine, an inducer itself, may also lower lorlatinib exposure, and both drugs carry hepatotoxicity risk. Lorlatinib labeling reports hepatotoxicity with strong CYP3A inducers.
How serious is the interaction between Lorlatinib and Nevirapine?
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 an alternative antiretroviral. If used together, monitor liver enzymes frequently and HIV viral load.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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