Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Lorbrena

Descriptions


Lorlatinib is used to treat metastatic (cancer that has already spread) non-small cell lung cancer in patients who have a certain type of abnormal anaplastic lymphoma kinase (ALK) gene. Your doctor will perform a test to check for the ALK gene before you use this medicine.

Lorlatinib is an antineoplastic (cancer) agent. It interferes with the growth of cancer cells, which are eventually destroyed by the body.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of lorlatinib in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lorlatinib in the elderly.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Carbamazepine
  • Enzalutamide
  • Fosphenytoin
  • Ivosidenib
  • Lumacaftor
  • Mavacamten
  • Mitotane
  • Phenytoin
  • Rifampin
  • St John's Wort

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abametapir
  • Acalabrutinib
  • Alfentanil
  • Amiodarone
  • Aprepitant
  • Atogepant
  • Avacopan
  • Avanafil
  • Avapritinib
  • Berotralstat
  • Boceprevir
  • Bosentan
  • Bosutinib
  • Brigatinib
  • Budesonide
  • Buprenorphine
  • Buspirone
  • Capivasertib
  • Capmatinib
  • Cenobamate
  • Clarithromycin
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Conivaptan
  • Cyclosporine
  • Daridorexant
  • Darifenacin
  • Darunavir
  • Dasatinib
  • Desogestrel
  • Dienogest
  • Digoxin
  • Dihydroergotamine
  • Dofetilide
  • Dronedarone
  • Drospirenone
  • Duvelisib
  • Efavirenz
  • Elacestrant
  • Eletriptan
  • Encorafenib
  • Entrectinib
  • Eplerenone
  • Erdafitinib
  • Ergotamine
  • Estetrol
  • Estradiol
  • Ethinyl Estradiol
  • Ethynodiol
  • Etonogestrel
  • Etravirine
  • Everolimus
  • Fedratinib
  • Felodipine
  • Fentanyl
  • Fexinidazole
  • Finerenone
  • Flibanserin
  • Fluconazole
  • Fluticasone
  • Fosaprepitant
  • Fruquintinib
  • Gestodene
  • Glasdegib
  • Ibrexafungerp
  • Ibrutinib
  • Idelalisib
  • Ifosfamide
  • Indinavir
  • Infigratinib
  • Itraconazole
  • Ivabradine
  • Ivacaftor
  • Ketoconazole
  • Larotrectinib
  • Lefamulin
  • Lemborexant
  • Lenacapavir
  • Leniolisib
  • Levonorgestrel
  • Lomitapide
  • Lopinavir
  • Lovastatin
  • Lumateperone
  • Lurasidone
  • Maraviroc
  • Medroxyprogesterone
  • Mestranol
  • Midazolam
  • Mitapivat
  • Mobocertinib
  • Modafinil
  • Nafcillin
  • Naloxegol
  • Nefazodone
  • Nelfinavir
  • Neratinib
  • Nirogacestat
  • Nomegestrol
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Oliceridine
  • Olutasidenib
  • Omaveloxolone
  • Oxycodone
  • Pacritinib
  • Palovarotene
  • Pemigatinib
  • Perampanel
  • Phenobarbital
  • Pimavanserin
  • Pimozide
  • Pirtobrutinib
  • Posaconazole
  • Pralsetinib
  • Praziquantel
  • Pretomanid
  • Primidone
  • Quetiapine
  • Quinidine
  • Quizartinib
  • Repotrectinib
  • Rifabutin
  • Rimegepant
  • Ripretinib
  • Ritonavir
  • Saquinavir
  • Segesterone
  • Selpercatinib
  • Selumetinib
  • Sildenafil
  • Simvastatin
  • Sirolimus
  • Sufentanil
  • Tacrolimus
  • Tazemetostat
  • Telaprevir
  • Telithromycin
  • Temsirolimus
  • Ticagrelor
  • Tipranavir
  • Tolvaptan
  • Tramadol
  • Triazolam
  • Ubrogepant
  • Ulipristal
  • Vardenafil
  • Venetoclax
  • Voclosporin
  • Vonoprazan
  • Voriconazole
  • Voxelotor
  • Zanubrutinib
  • Zolpidem
  • Zuranolone

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Depression, history of or
  • Diabetes or
  • Heart rhythm problems or
  • Hyperglycemia (high blood sugar) or
  • Hyperlipidemia (high fat in the blood) or
  • Hypertension (high blood pressure) or
  • Lung or breathing problems or
  • Seizures, history of—Use with caution. May make these conditions worse.
  • Kidney disease, severe or
  • Liver disease, moderate or severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

You may take this medicine with or without food.

Swallow the tablet whole. Do not chew, crush, or split it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For non-small cell lung cancer:
      • Adults—100 milligrams (mg) once a day. Your doctor may adjust your dose as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose this medicine and it is within 4 hours of your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take extra medicine to make up for a missed dose. Do not take extra medicine if you vomit.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. If you are a woman who can get pregnant, your doctor may do tests before you start using this medicine to make sure you are not pregnant. Birth control pills may not work as well to prevent pregnancy when used with this medicine. Use another form of birth control (eg, condoms, spermicide) along with your pills. Female patients should use effective birth control during treatment and for at least 6 months after the last dose. Male patients who have female partners should use effective birth control during treatment and for at least 3 months after the last dose. If you think you have become pregnant while using this medicine, tell your doctor right away.

Talk with your doctor before using this medicine if you plan to have children. Some men who use this medicine have become infertile (unable to have children).

Do not use this medicine together with rifampin (Rifadin®). Using these medicines together may increase risk for serious liver problems.

Cancer medicines can cause diarrhea, nausea, vomiting, or stomach pain in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these unwanted effects.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause brain or nerve problems. Check with your doctor right away if you have changes in your behavior, discouragement, feeling sad or empty, irritability, lack of appetite, loss of interest or pleasure, seizures, thoughts of killing oneself, tiredness, trouble concentrating, or trouble sleeping.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a slow, fast, pounding, or uneven heartbeat.

This medicine may cause swelling of the lungs (pneumonitis) or interstitial lung disease. These are life-threatening conditions and require immediate medical attention. The symptoms may be similar to the symptoms of lung cancer. Check with your doctor right away if you have new or worsening cough, fever, or trouble breathing.

You will need to have your blood pressure measured before starting this medicine and while you are using it. If you notice any change to your recommended blood pressure, call your doctor right away. Symptoms of high blood pressure are blurred vision, severe headache, a slow or fast heartbeat, lightheadedness, or dizziness.

This medicine may affect your blood sugar levels. Check with your doctor right away if you have increased thirst or increased urination. If you notice a change in the results of your urine or blood sugar tests, or if you have any questions, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Actions that are out of control
  2. aggression
  3. agitation
  4. anxiety
  5. black, tarry stools
  6. bleeding gums
  7. blood in the urine or stools
  8. blurred vision or other changes in vision
  9. body aches or pain
  10. burning, crawling, itching, numbness, prickling, "pins and needles", tingling, or painful sensations
  11. changes in behavior
  12. chills
  13. cough
  14. defects in intelligence, short-term memory, learning ability, and attention
  15. difficult or labored breathing
  16. difficulty in breathing
  17. discouragement
  18. dizziness
  19. dry mouth
  20. ear congestion
  21. false or unusual sense of well-being
  22. feeling sad or empty
  23. fever
  24. flushed, dry skin
  25. fruit-like breath odor
  26. headache
  27. hoarseness
  28. increased hunger
  29. increased thirst
  30. increased urination
  31. irritability
  32. lack of appetite
  33. loss of interest or pleasure
  34. loss of voice
  35. lower back or side pain
  36. nausea
  37. nervousness
  38. painful or difficult urination
  39. pale skin
  40. pinpoint red spots on the skin
  41. pounding in the ears
  42. runny or stuffy nose
  43. seeing, hearing, or feeling things that are not there
  44. skin rash
  45. slow or fast heartbeat
  46. sneezing
  47. sore throat
  48. stomach pain
  49. sweating
  50. swelling
  51. talking, feeling, and acting with excitement
  52. thoughts of killing oneself
  53. tightness in the chest
  54. trouble concentrating
  55. trouble sleeping
  56. trouble breathing
  57. unexplained weight loss
  58. unsteadiness or awkwardness
  59. unusual bleeding or bruising
  60. unusual tiredness or weakness
  61. vomiting
  62. weakness in the arms, hands, legs, or feet

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Abnormal dreams
  2. back pain
  3. constipation
  4. difficulty in moving
  5. difficulty in speaking
  6. drowsiness
  7. joint pain
  8. muscle aches, cramps, pains, or stiffness
  9. pain in the arms or legs
  10. sleep talking
  11. swollen joints

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: April 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/lorlatinib-oral-route/proper-use/drg-20452266