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Drug interactions

Lorlatinib + Pimozide

Severity: Major

Lorlatinib and Pimozide: 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 may reduce pimozide concentrations, causing loss of effect. Lorlatinib can also prolong the PR interval, adding a cardiac conduction concern.

What this interaction means in plain words

Lorlatinib and Pimozide 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; Pimozide belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Lorlatinib induction of CYP3A4 increases pimozide metabolism.

What to do

Avoid the combination if possible; if not, monitor clinical response and ECG and adjust pimozide cautiously. Reassess the dose when lorlatinib is stopped.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Lorlatinib with Pimozide?

MediHelp rates the interaction as major. Lorlatinib and Pimozide 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 may reduce pimozide concentrations, causing loss of effect. Lorlatinib can also prolong the PR interval, adding a cardiac conduction concern.

How serious is the interaction between Lorlatinib and Pimozide?

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 if possible; if not, monitor clinical response and ECG and adjust pimozide cautiously. Reassess the dose when lorlatinib is stopped.

What other medicines interact with Pimozide?

MediHelp also lists interactions of Pimozide with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Pimozide page.

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