Drug interactions
Lorlatinib + Sofosbuvir-velpatasvir-voxilaprevir
Severity: Major
Lorlatinib and Sofosbuvir-velpatasvir-voxilaprevir: 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
Lorlatinib is a CYP3A4 inducer and may lower velpatasvir and voxilaprevir concentrations, risking reduced HCV cure rates. It may also be a P-gp inducer with similar effect on sofosbuvir. Lorlatinib exposure itself is not expected to change meaningfully.
What this interaction means in plain words
Lorlatinib and Sofosbuvir-velpatasvir-voxilaprevir 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; Sofosbuvir-velpatasvir-voxilaprevir belongs to Anti Virals.
Why it happens
Lorlatinib induces CYP3A4 and possibly P-gp, lowering exposure to the antiviral components.
What to do
Avoid combination; defer HCV treatment or use a regimen without induction sensitivity.
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 Sofosbuvir-velpatasvir-voxilaprevir
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenobarbital + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifampin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir 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 Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates the interaction as major. Lorlatinib and Sofosbuvir-velpatasvir-voxilaprevir 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 is a CYP3A4 inducer and may lower velpatasvir and voxilaprevir concentrations, risking reduced HCV cure rates. It may also be a P-gp inducer with similar effect on sofosbuvir. Lorlatinib exposure itself is not expected to change meaningfully.
How serious is the interaction between Lorlatinib and Sofosbuvir-velpatasvir-voxilaprevir?
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 combination; defer HCV treatment or use a regimen without induction sensitivity.
What other medicines interact with Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir-voxilaprevir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Sofosbuvir-velpatasvir-voxilaprevir page.
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