What is this medication?
LORLATINIB (lor LA ti nib) treats lung cancer. It works by blocking a protein that causes cancer cells to grow and multiply. This helps to slow or stop the spread of cancer cells.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
COMMON BRAND NAME(S): Lorbrena
What should I tell my care team before I take this medication?
They need to know if you have any of these conditions:
- High blood pressure
- High cholesterol
- Irregular heartbeat or rhythm
- Kidney disease
- Lung disease
- Mental health condition
- Scarring or thickening of the lungs
- Suicidal thoughts, plans, or attempt by you or a family member
- An unusual or allergic reaction to lorlatinib, other medications, foods, dyes, or preservatives
- Pregnant or trying to get pregnant
How should I use this medication?
Take this medication by mouth. Take it as directed on the prescription label at the same time every day. Do not cut, crush, or chew this medication. Swallow the tablets whole. You can take it with or without food. If it upsets your stomach, take it with food. Keep taking it unless your care team tells you to stop.
Do not take this medication with grapefruit juice.
Talk to your care team about the use of this medication in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?
If you miss a dose, take it as soon as you can unless it is less than 4 hours before the next dose. If it is less than 4 hours before the next dose, skip the missed dose. Take the next dose at the normal time.
What may interact with this medication?
Do not take this medication with any of the following:
- Certain medications for seizures, such as carbamazepine, phenytoin, mephobarbital, phenobarbital, primidone
- Lumacaftor; ivacaftor
- St. John's wort
This medication may also interact with the following:
- Certain antibiotics, such as clarithromycin or troleandomycin
- Certain antivirals for hepatitis, such as boceprevir or telaprevir
- Certain antivirals for HIV, such as cobicistat, indinavir, lopinavir, ritonavir, saquinavir, tipranavir, efavirenz, etravirine
- Certain medications for fungal infections, such as fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole
- Estrogen or progestin hormones
- Grapefruit juice
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medication?
Visit your care team for regular checks on your progress. It may be some time before you see the benefit from this medication.
This medication may make you feel generally unwell. This is not uncommon as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your care team tells you to stop.
Talk to your care team if you wish to become pregnant or think you might be pregnant. This medication can cause serious birth defects if taken during pregnancy or for 6 months after the last dose. A negative pregnancy test is required before starting this medication. Estrogen and progestin hormones may not work as well while you are taking this medication. A barrier contraceptive, such as condom or diaphragm, is recommended. Talk to your care team about reliable forms of contraception. Do not father a child while taking this medication and for 3 months after the last dose. Use a condom when having sex during this time period.
Do not breast-feed while taking this medication and for 7 days after the last dose.
This medication may cause infertility. It is usually temporary. Talk to your care team if you are concerned about your fertility.
Avoid taking medications that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your care team. These medications may hide a fever.
Be careful brushing or flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medication.
This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.
This medication can increase bad cholesterol and fats (such as LDL, triglycerides) and decrease good cholesterol (HDL) in your blood. You may need blood tests to check your cholesterol. Ask your care team what you can do to lower your risk of high cholesterol while taking this medication.
This medication may increase blood sugar. The risk may be higher in patients who already have diabetes. Ask your care team what you can do to lower your risk of diabetes while taking this medication.
This medication may cause thoughts of suicide or depression. This includes sudden changes in mood, behaviors, or thoughts. These changes can happen at any time but are more common in the beginning of treatment or after a change in dose. Call your care team right away if you experience these thoughts or worsening depression.
What side effects may I notice from receiving this medication?
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dry cough, shortness of breath or trouble breathing
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Increase in blood pressure
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Pain, tingling, or numbness in the hands or feet, muscle weakness, change in vision, confusion or trouble speaking, loss of balance or coordination, trouble walking, seizures
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Joint pain
- Swelling of the ankles, hands, or feet
- Weight gain
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medication?
Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Get rid of any unused medication after the expiration date.
To get rid of medications that are no longer needed or have expired:
- Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
- If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.
NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.
Additional Information From Chemocare.com About Lorlatinib
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
- You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
- Follow regimen of anti-diarrhea medications as prescribed by your health care provider.
- Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
- Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
- If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
When to Contact Your Doctor or Health Care Provider
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
- Fever of 100.4º F (38º C) or higher, chills (possible signs of infection)
- New or worsening cardiac symptoms (slow or abnormal heart beats, dizziness, or fainting)
- New or worsening respiratory symptoms (trouble breathing, shortness of breath, or cough)
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
- Nausea (interferes with ability to eat and unrelieved with prescribed medication)
- Vomiting (vomiting more than 4-5 times in a 24-hour period)
- Diarrhea (4-6 episodes in a 24-hour period)
- Constipation unrelieved by laxative use
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools
- Blood in the urine
- Changes in vision
- Extreme fatigue (unable to carry on self-care activities)
- Yellowing of the skin or eyes
- Tingling or burning, redness, swelling of the palms of the hands or soles of the feet
- Swelling of the feet or ankles. Sudden weight gain
- Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness
Always inform your health care provider if you experience any unusual symptoms.