Drug interactions
Lorlatinib + Ombitasvir / paritaprevir / ritonavir
Severity: Major
Lorlatinib and Ombitasvir / paritaprevir / ritonavir: 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
Lorlatinib is a CYP3A inducer and can lower exposure to paritaprevir and the ritonavir booster, which depend on CYP3A-mediated pharmacokinetics. Reduced antiviral concentrations could lead to loss of hepatitis C virologic response and possible resistance. Ritonavir may also raise lorlatinib levels.
What this interaction means in plain words
Lorlatinib and Ombitasvir / paritaprevir / ritonavir 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
Lorlatinib induces CYP3A4, increasing metabolism of paritaprevir and ritonavir.
What to do
Avoid the combination and choose an alternative HCV regimen that is not CYP3A-dependent, or an alternative ALK inhibitor. If unavoidable, monitor HCV RNA and lorlatinib adverse effects (lipids, CNS effects, liver enzymes).
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 Ombitasvir / paritaprevir / ritonavir?
MediHelp rates the interaction as major. Lorlatinib and Ombitasvir / paritaprevir / ritonavir 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 CYP3A inducer and can lower exposure to paritaprevir and the ritonavir booster, which depend on CYP3A-mediated pharmacokinetics. Reduced antiviral concentrations could lead to loss of hepatitis C virologic response and possible resistance. Ritonavir may also raise lorlatinib levels.
How serious is the interaction between Lorlatinib and Ombitasvir / paritaprevir / ritonavir?
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 and choose an alternative HCV regimen that is not CYP3A-dependent, or an alternative ALK inhibitor. If unavoidable, monitor HCV RNA and lorlatinib adverse effects (lipids, CNS effects, liver enzymes).
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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