Drug interactions
Lorlatinib + Tolvaptan
Severity: Moderate
Lorlatinib and Tolvaptan: 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 may lower tolvaptan concentrations through CYP3A induction. Reduced aquaretic effect and inadequate correction of hyponatremia or slower disease control may follow.
What this interaction means in plain words
Lorlatinib and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Lorlatinib induces CYP3A4, increasing the metabolism of tolvaptan, a CYP3A substrate.
What to do
Monitor serum sodium or urine output response and adjust the tolvaptan dose as needed. Consider an alternative if the response is inadequate.
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 Lorlatinib
- Amobarbital + Lorlatinib Contraindicated
- Apalutamide + Lorlatinib Contraindicated
- Butabarbital + Lorlatinib Contraindicated
- Carbamazepine + Lorlatinib Contraindicated
- Enzalutamide + Lorlatinib Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Lorlatinib with Tolvaptan?
MediHelp rates the interaction as moderate. Lorlatinib and Tolvaptan 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 may lower tolvaptan concentrations through CYP3A induction. Reduced aquaretic effect and inadequate correction of hyponatremia or slower disease control may follow.
How serious is the interaction between Lorlatinib and Tolvaptan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum sodium or urine output response and adjust the tolvaptan dose as needed. Consider an alternative if the response is inadequate.
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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