Lorlatinib

Lorlatinib is used to treat a certain type of non-small cell lung cancer (NSCLC). Lorlatinib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps to stop or slow the spread of cancer cells.

Lorlatinib comes as a tablet to take by mouth. Take with or without food once daily. Take lorlatinib at around the same time every day. 

Take lorlatinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you vomit after taking the medication, do not take another dose. Continue your regular dosing schedule.

Swallow the tablets whole; do not split, chew, or crush them. Do not take tablets that are already broken or cracked.

Your doctor may decrease your dose or temporarily or permanently stop your treatment depending on if you experience any side effects. Be sure to tell your doctor how you are feeling during your treatment with lorlatinib.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking lorlatinib,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• some medications should not be taken with lorlatinib. Other medications may cause dosing changes or extra monitoring when taken with lorlatinib Make sure you have discussed any medications you are currently taking or plan to take before starting lorlatinib with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking lorlatinib, please get the advice of your doctor or pharmacist
• you should know that loratinib may decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, and injections). You will need to use another method of contraception to prevent pregnancy while taking loratinib. Talk to your doctor about other ways to prevent pregnancy while you are taking this medication.
• the following herbal product may interact with lorlatinib: St. John's wort. Be sure to let your doctor and pharmacist know that you are taking this medication before you start taking lorlatinib. Do not start this medication while taking lorlatinib without discussing with your healthcare provider.
• tell your doctor if you have or have ever had high blood pressure, an irregular heartbeat, diabetes or high blood sugar levels, depression, seizures, high levels of cholesterol and other fatty substances in the blood, or kidney, liver, or lung disease.
• you may be required to have a pregnancy test prior to starting loratinib. You should use birth control during and for 6 months after treatment with loratinib. Talk to your doctor about what birth control is right for you. If your partner is capable of becoming pregnant, you should use birth control during and for 3 months after treatment with loratinib. Talk to your doctor about what birth control would work best for you and your partner.
• tell your doctor if you are breast-feeding. Do not breast-feed while you are taking lorlatinib and for 7 days after your final dose.
• you should know that this medication may temporarily decrease fertility in men. Talk to your doctor about the risks of taking lorlatinib.

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medication.

Take the missed dose as soon as you remember it. However, if it is within 4 hours of the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Lorlatinib may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• weight gain
• nausea, vomiting, diarrhea, constipation
• tiredness
• rash or itching
• swelling in your arms, legs, hands and feet

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• shortness of breath, cough, or fever
• numbness and tingling feeling in your joints or arms and legs
• difficulty thinking or confusion
• seeing things or hearing voices that do not exist
• changes in mood, feeling sad or anxious
• problems with speech
• difficulty falling asleep or staying asleep, unusual dreams or nightmares
• headache, dizziness, blurred vision, feeling faint, chest pain, or shortness of breath
• feeling more hungry or thirsty than usual, increased urination, extreme tiredness, weakness, confusion, or breath that smells fruity

Lorlatinib may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests and an electrocardiogram (ECG; test that measures the electrical activity in the heart) before and during your treatment to check your body's response to lorlatinib. Your doctor will also check your blood pressure before and during your treatment.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

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