Drug interactions
Lorlatinib + Voxelotor
Severity: Major
Lorlatinib and Voxelotor: 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 induces CYP3A4 and may lower voxelotor exposure, while voxelotor may inhibit CYP3A4 and raise lorlatinib levels. The effects pull in opposite directions, so net exposure of either drug is unpredictable. This could mean reduced voxelotor efficacy or lorlatinib toxicity such as hyperlipidaemia and CNS effects.
What this interaction means in plain words
Lorlatinib and Voxelotor 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; Voxelotor belongs to Miscellaneous.
Why it happens
Bidirectional CYP3A4 effects: lorlatinib induces voxelotor metabolism, and voxelotor inhibits CYP3A4-mediated lorlatinib metabolism.
What to do
Avoid the combination if possible. If used together, monitor lorlatinib adverse effects (lipids, mood, cognition) and voxelotor response such as haemoglobin.
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 Lorlatinib
- Amobarbital + Lorlatinib Contraindicated
- Apalutamide + Lorlatinib Contraindicated
- Butabarbital + Lorlatinib Contraindicated
- Carbamazepine + Lorlatinib Contraindicated
- Enzalutamide + Lorlatinib Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
Other interactions of Voxelotor
- Amobarbital + Voxelotor Major
- Apalutamide + Voxelotor Major
- Carbamazepine + Voxelotor Major
- Cyclosporin + Voxelotor Major
- Efavirenz + Voxelotor Major
- Enzalutamide + Voxelotor Major
Frequently asked questions
Can I take Lorlatinib with Voxelotor?
MediHelp rates the interaction as major. Lorlatinib and Voxelotor 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 induces CYP3A4 and may lower voxelotor exposure, while voxelotor may inhibit CYP3A4 and raise lorlatinib levels. The effects pull in opposite directions, so net exposure of either drug is unpredictable. This could mean reduced voxelotor efficacy or lorlatinib toxicity such as hyperlipidaemia and CNS effects.
How serious is the interaction between Lorlatinib and Voxelotor?
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 together, monitor lorlatinib adverse effects (lipids, mood, cognition) and voxelotor response such as haemoglobin.
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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