Drug interactions
Lorlatinib + Pretomanid
Severity: Major
Lorlatinib and Pretomanid: major interaction.
Last updated
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
Pretomanid is partly metabolized by CYP3A4, and induction by lorlatinib may lower its concentrations. This could compromise tuberculosis treatment efficacy and promote resistance.
What this interaction means in plain words
Lorlatinib and Pretomanid 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; Pretomanid belongs to Anti Bacterial.
Why it happens
Lorlatinib induces CYP3A4, increasing pretomanid metabolism.
What to do
Avoid coadministration and consider an alternative anti-TB regimen or ALK inhibitor. If unavoidable, monitor clinical and microbiological response closely.
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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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 Pretomanid
Frequently asked questions
Can I take Lorlatinib with Pretomanid?
MediHelp rates the interaction as major. Lorlatinib and Pretomanid 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. Pretomanid is partly metabolized by CYP3A4, and induction by lorlatinib may lower its concentrations. This could compromise tuberculosis treatment efficacy and promote resistance.
How serious is the interaction between Lorlatinib and Pretomanid?
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 coadministration and consider an alternative anti-TB regimen or ALK inhibitor. If unavoidable, monitor clinical and microbiological response closely.
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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