Drug interactions
Lorlatinib + Siponimod
Severity: Moderate
Lorlatinib and Siponimod: moderate 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
Lorlatinib is a moderate CYP3A4 inducer and may lower siponimod concentrations, potentially reducing efficacy. The effect is larger in patients with CYP2C9*1/*3 or *2/*3 genotype.
What this interaction means in plain words
Lorlatinib and Siponimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Lorlatinib belongs to Oncology; Siponimod belongs to Central Nervous System.
Why it happens
Lorlatinib induces CYP3A4, increasing siponimod clearance.
What to do
Avoid in patients with CYP2C9*1/*3 or *2/*3 genotype. Otherwise monitor for reduced response to siponimod.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Siponimod
- Cladribine + Siponimod Contraindicated
- Fingolimod + Siponimod Contraindicated
- Fluconazole + Siponimod Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine 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 Siponimod?
MediHelp rates the interaction as moderate. Lorlatinib and Siponimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lorlatinib is a moderate CYP3A4 inducer and may lower siponimod concentrations, potentially reducing efficacy. The effect is larger in patients with CYP2C9*1/*3 or *2/*3 genotype.
How serious is the interaction between Lorlatinib and Siponimod?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid in patients with CYP2C9*1/*3 or *2/*3 genotype. Otherwise monitor for reduced response to siponimod.
What other medicines interact with Siponimod?
MediHelp also lists interactions of Siponimod with, for example, Cladribine, Fingolimod, Fluconazole. The full list is on the Siponimod page.
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