Drug interactions
Lorlatinib + Sofosbuvir / velpatasvir
Severity: Major
Lorlatinib and Sofosbuvir / velpatasvir: 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
Velpatasvir is metabolized partly by CYP3A4 and sofosbuvir is a P-gp substrate; lorlatinib induces CYP3A and P-gp potential, possibly reducing concentrations. This may lower antiviral efficacy and risk virologic failure.
What this interaction means in plain words
Lorlatinib and Sofosbuvir / velpatasvir 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.
Why it happens
Lorlatinib induces CYP3A4 (and possibly P-gp), lowering sofosbuvir and velpatasvir exposure.
What to do
Avoid the combination if possible; if used, monitor HCV RNA for virologic response.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Lorlatinib and Sofosbuvir / velpatasvir, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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?
MediHelp rates the interaction as major. Lorlatinib and Sofosbuvir / velpatasvir 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. Velpatasvir is metabolized partly by CYP3A4 and sofosbuvir is a P-gp substrate; lorlatinib induces CYP3A and P-gp potential, possibly reducing concentrations. This may lower antiviral efficacy and risk virologic failure.
How serious is the interaction between Lorlatinib and Sofosbuvir / velpatasvir?
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 if possible; if used, monitor HCV RNA for virologic response.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
