Drug interactions
Lorlatinib + Norgestrel
Severity: Major
Lorlatinib and Norgestrel: 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 induces CYP3A4 and can reduce hormonal contraceptive levels. This may lead to contraceptive failure, a concern given lorlatinib's fetal risk.
What this interaction means in plain words
Lorlatinib and Norgestrel 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; Norgestrel belongs to Endocrine.
Why it happens
Lorlatinib induces CYP3A4, increasing metabolism of norgestrel.
What to do
Do not rely on hormonal contraception alone; use a non-hormonal method such as a copper IUD or consistent barrier methods during and after lorlatinib therapy.
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
- Lorviqua 100 mg film coated tablets - SmPC sections 4.3/4.5 (class statement: hormonal contraceptives; "including but not limited to alfentanil, ciclosporin, dihydroergotamine, ergotamine, fentanyl, hormonal contraceptives, pimozide, quinidine, sirolimus and tacro") — electronic medicines compendium (UK SmPC)
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 Norgestrel
- Amobarbital + Norgestrel Major
- Apalutamide + Norgestrel Major
- Bosentan + Norgestrel Major
- Carbamazepine + Norgestrel Major
- Efavirenz + Norgestrel Major
- Enzalutamide + Norgestrel Major
Frequently asked questions
Can I take Lorlatinib with Norgestrel?
MediHelp rates the interaction as major. Lorlatinib and Norgestrel 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 induces CYP3A4 and can reduce hormonal contraceptive levels. This may lead to contraceptive failure, a concern given lorlatinib's fetal risk.
How serious is the interaction between Lorlatinib and Norgestrel?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not rely on hormonal contraception alone; use a non-hormonal method such as a copper IUD or consistent barrier methods during and after lorlatinib 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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