Lorlatinib is used to treat a certain type of lung cancer (non-small cell lung cancer) that has spread to other parts of the body which is caused by a defect in a gene called ALK (anaplastic lymphoma kinase).
It is used for those who have failed previous therapy with crizotinib and at least 1 other ALK inhibitor, or alectinib or ceritinib.
Take Lorlatinib exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Swallow it whole with a glass of water. Do not divide, chew or crush the tablet.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to this medication.
Lorlanitib must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is 4 hours or less before the next dose is due, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Do not take this medicine if you are pregnant. If you become pregnant while on Lorlatinib therapy, alert your doctor immediately. This medicine may cause harm to your unborn child.
It is important that you do not get pregnant while taking this medicine. You must use proven birth control methods during Lorlatinib therapy and for at least 6 months after stopping the treatment. Birth control medicines containing hormones may not be effective. You may wish to discuss other reliable methods of birth control with your doctor. Avoid fathering a child during treatment and for 3 months after completion of treatment.
Do not breastfeed while you are being treated with this medicine and for 7 days after stopping the treatment.
Do not take Lorlatinib with certain medicines known as strong CYP3A inducers. Please see the section “Can I take this with other medicines?” below for more information.
Inform your doctor if you have the following conditions:
- moderate to severe liver disease
- severe kidney disease
To know if Lorlatinib is suited for you, your doctor may need to check if you are a carrier of the ALK gene by performing genetic test before starting treatment with Lorlatinib.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if this medicine is suited for you to take.
- Routine tests (e.g. liver function, cholesterol or enzyme levels, ECG) may be done while you are being treated with this medicine.
- Regular monitoring for signs of a lung disease called pneumonitis (inflammation of lung tissue) and other side effects (e.g. seizures, hallucinations) may also be needed.
Your doctor will advise you about how often you need to have these tests.
Lorlatinib may cause certain side effects such as seizures or confusion. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: constipation, diarrhoea, nausea, headache, weight gain, limb or skin swelling, eye problems, joint or muscle pain, numbness in your arms or legs, and rash.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- chest pain, shortness of breath or breathing problems
- changes in cognition e.g. confusion, memory loss, reduced ability to concentrate
- difficulty speaking e.g. slurred or slow speech
- unusual changes in mood or behaviour (being too depressed, irritable, agitated, or having compulsive and impulsive behaviour)
- seeing, hearing or feeling things that are not existent
- having thoughts of self-harm
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Lorlatinib if you are taking any of these medicines:
- rifampicin (medicine to treat lung infection known as TB)
- medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine
- medicines for cancer e.g. enzalutamide, mitotane
- St. John’s wort (herbal medicine)
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat fungal infection e.g. ketoconazole, itraconazole
- medicines used in organ transplant or certain immune disorders e.g. ciclosporin, sirolimus, tacrolimus
- medicines for HIV infection e.g. ritonavir, indinavir
- boceprevir (medicine to treat hepatitis C)
- fentanyl (strong painkillers)
- medicines to treat migraine e.g. dihydroergotamine, ergotamine
- troleandomycin (antibiotic)
- quinidine (medicine to treat abnormal heart rhythm)
- pimozide (medicine for mood disorders)
- digoxin (medicine to treat heart failure)
- dabigatran (blood-thinning medicine)
This list does not include all medicines that may interact with Lorlatinib.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
As this is a cancer medicine, always return any unused or expired tablets to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.