lorlatinib
Other Name: Lorbrena®
in various strengths, shapes and colours
- For treating a certain type of non-small cell lung cancer (NSCLC)
Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
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any history of mental health problems
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high fat levels in your blood (cholesterol or triglycerides)
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high blood sugar or diabetes
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high blood pressure
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heart problems (including irregular heart beat)
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lung, liver, kidney, pancreas problems, or
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any allergies.
Lorlatinib tablets contain a small amount of lactose. If you cannot have lactose, talk to your health care team.
Remember to:
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Tell your health care team about all of the other medications you are taking.
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Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
Talk to your health care team about:
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How this medication may affect your sexual health.
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How this medication may affect your ability to have a baby, if this applies to you.
This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
- If there is any chance you may become pregnant, you and your partner together must use 2 effective forms of birth control at the same time until 21 days after your last dose. Talk to your health care team about which birth control options are best for you.
- If you are a patient that can get somebody pregnant, you and your partner together must use 2 effective forms of birth control at the same time until 97 days after your last dose. Talk to your health care team about which birth control options are best for you.
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This medication may make hormonal birth control, such as birth control pills, less effective (not work as well). If you choose to use a hormonal birth control, make sure you also use a barrier or non-hormonal birth control method (such as condoms). Talk to your health care team about the best birth control options for you.
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Do not breastfeed while on this medication and for 7 days after the last dose.
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This medication is usually taken once a day by mouth. Talk to your health care team about how and when to take your medication.
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Take the dose at about the same time each day.
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Swallow whole with a glass of water, with or without food.
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Do not crush, chew or split the tablets.
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If you miss a dose, take it as soon as you remember. If it is close to your next dose (within 4 hours), just skip this dose and take your next dose at the scheduled time. Do not take two doses at the same time to make up for a missed dose.
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If you vomit (throw up) after taking your medication, do not take an extra dose; just take your next dose at the scheduled time.
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If you take too much of your oral anticancer medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.
Will this medication interact with other medications or natural health products?
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This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
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Tell your health care team about all of your:
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prescription and over-the-counter (non-prescription) medications and all other drugs, such as marijuana (medical or recreational)
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natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
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Check with your health care team before starting or stopping any of them.
What should I do if I feel unwell, have pain, a headache or a fever?
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Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol) or ibuprofen (Advil)).
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Fever can be a sign of infection that may need treatment right away.
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If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
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How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
- You have a fever if your temperature taken in your mouth (oral temperature) is:
- 38.3°C (100.9°F) or higher at any time
OR
- 38.0°C (100.4°F) or higher for at least one hour.
- 38.3°C (100.9°F) or higher at any time
If you do have a fever:
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Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
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Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
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Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
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Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
What to DO while on this medication:
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DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
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DO tell your health care team if you have any new pain, numbness or tingling of your hands or feet. This is especially important if you are having trouble doing tasks (like doing up buttons, writing, walking) or if you have severe pain or numbness.
- DO tell your health care team if you start peeing more often than usual and are extremely thirsty.
What NOT to DO while on this medication:
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DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects.
- DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel tired or dizzy.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
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Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.
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How to safely touch oral anti-cancer medications
If you are a patient:
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Wash your hands before and after touching your oral anti-cancer medication.
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Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
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Wear nitrile or latex gloves when touching tablets, capsules or liquids.
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Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
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Throw out your gloves after each use. Do not re-use gloves.
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Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
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What to do if oral anti-cancer medication gets on your skin or in your eyes
If medication gets on your skin:
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Wash your skin with a lot of soap and water.
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If your skin gets red or irritated, talk to your health care team.
If medication gets in your eyes:-
Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
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The following table lists side effects that you may have when getting lorlatinib. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on lorlatinib.
Very Common Side Effects (50 or more out of 100 people) | |
Side effects and what to do | When to contact health care team |
Higher than normal cholesterol or fat levels in the blood (May be severe) What to look for? High cholesterol or fat levels do not usually cause any symptoms. Since your medication may cause high cholesterol, your health care team may do regular blood tests to check your cholesterol levels. What to do?
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Talk to your health care team if it does not improve or if it is severe. |
Mild swelling What to look for?
What to do? To help prevent swelling:
If you have swelling:
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Talk to your health care team if it does not improve or if it is severe. |
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Weight gain What to look for?
What to do?
If you notice you’re gaining weight, talk to your health care team to find out what may be causing this and what to do. |
Talk to your health care team if it does not improve or if it is severe. |
Neuropathy (Tingling, numb toes or fingers) What to look for?
What to do?
In rare cases, it may continue long after treatment ends. If you continue to have bothersome symptoms, talk to your health care team for advice. |
Talk to your health care team, especially if you have trouble doing tasks like doing up buttons, writing, moving, severe pain or numbness. |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Effects on your brain or how you think What to look for?
What to do? If you have any of these symptoms, get emergency medical help right away. |
Get emergency medical help right away. |
Diarrhea What to look for?
What to do? If you have diarrhea:
Ask your health care team for the Diarrhea pamphlet for more information. |
Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day). |
Cough and feeling short of breath What to look for?
What to do?
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Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away. |
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Headache; Mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Anemia (low red blood cells) What to look for?
What to do? If your health care team has told you that you have anemia (low red blood cells):
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Talk to your health care team if it does not improve or if it is severe. |
High blood pressure (May be severe) What to look for?
What to do?
If you have a severe headache get emergency help right away as it may be a sign your blood pressure is too high.
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Talk to your health care team if it does not improve or if it is severe. |
Eye problems What to look for?
What to do?
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Talk to your health care team as soon as possible. |
Liver problems Your health care team may check your liver function with a blood test. The liver changes do not usually cause any symptoms. What to look for?
What to do? If you have any symptoms of liver problems, get emergency medical help right away.
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Get emergency medical help right away. |
Constipation What to look for?
What to do? To help prevent constipation:
To help treat constipation:
Ask your health care team for the Constipation Pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
Mood changes What to look for?
What to do?
Talk to your health care team if your mood changes do not improve or if they are severe. |
Talk to your health care team if it does not improve or if it is severe. |
Dizziness What to look for?
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Talk to your health care team if it does not improve or if it is severe. |
Changes in your speech (how you talk and understand words) What to look for?
What to do? Talk to your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. |
Talk to your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. |
Trouble Sleeping Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends. What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe. |
Nausea and vomiting (Generally mild) What to look for?
What to do? To help prevent nausea:
If you have nausea or vomiting:
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Talk to your health care team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if severe. |
Rash; dry, itchy skin What to look for?
What to do? To prevent and treat dry skin:
Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away. |
Talk to your health care team if it does not improve or if it is severe. |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
- irregular heartbeat, shortness of breath, chest pain or fainting spells
- feeling very thirsty, tired, weak or confused, peeing more often than usual
- new leg pain when walking, weakness, or cramping in muscles
- pain, swelling and hardening of the vein in an arm or leg
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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September 2023 Updated "What should I do before I have this medication" and "How will this medication affect sex, pregnancy and breastfeeding?" sections
For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.