Drug interactions
Lorlatinib + Quinine
Severity: Major
Lorlatinib and Quinine: 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 induces CYP3A4, the main enzyme metabolizing quinine, which may lower quinine concentrations and cause treatment failure in malaria or other uses. Lorlatinib can also prolong the PR interval, which adds cardiac considerations.
What this interaction means in plain words
Lorlatinib and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Induction of CYP3A4 by lorlatinib increases quinine clearance.
What to do
Avoid the combination when quinine is used for treatment of malaria, using an alternative antimalarial. If unavoidable, monitor clinical 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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References
Other interactions of Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
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 Quinine?
MediHelp rates the interaction as major. Lorlatinib and Quinine 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, the main enzyme metabolizing quinine, which may lower quinine concentrations and cause treatment failure in malaria or other uses. Lorlatinib can also prolong the PR interval, which adds cardiac considerations.
How serious is the interaction between Lorlatinib and Quinine?
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 when quinine is used for treatment of malaria, using an alternative antimalarial. If unavoidable, monitor clinical response closely.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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