Drug interactions
Lorlatinib + Rifabutin
Severity: Contraindicated
Lorlatinib and Rifabutin: contraindicated 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
Rifabutin induces CYP3A4 and can lower lorlatinib exposure, risking loss of efficacy. Strong CYP3A inducers given with lorlatinib have been associated with raised liver enzymes. Labeling prohibits the combination.
What this interaction means in plain words
Lorlatinib and Rifabutin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Lorlatinib belongs to Oncology; Rifabutin belongs to Anti Bacterial.
Why it happens
CYP3A4 induction increases lorlatinib metabolism and lowers its plasma concentration.
What to do
Do not use together; choose a non-inducing alternative for the indication. If an inducer is necessary, stop it for about 3 half-lives before lorlatinib.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
- Clarithromycin + Rifabutin Major
Frequently asked questions
Can I take Lorlatinib with Rifabutin?
MediHelp rates the interaction as contraindicated. Lorlatinib and Rifabutin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Rifabutin induces CYP3A4 and can lower lorlatinib exposure, risking loss of efficacy. Strong CYP3A inducers given with lorlatinib have been associated with raised liver enzymes. Labeling prohibits the combination.
How serious is the interaction between Lorlatinib and Rifabutin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; choose a non-inducing alternative for the indication. If an inducer is necessary, stop it for about 3 half-lives before lorlatinib.
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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