Lorlatinib

Say it: lor-LA-tih-nib · Brand names: Lorbrena

Lorlatinib is a targeted pill that blocks a growth signal in lung cancers with a change in the ALK gene.

What it is

Some lung cancers have a change in a gene called ALK. Lorlatinib blocks the ALK signal, even in some cancers that stopped responding to other ALK pills. It also reaches the brain well.

Often used for

• non-small cell lung cancer with an ALK gene change

How you get it

It is a pill you take by mouth once a day, with or without food. People usually take it for as long as it works and side effects are OK. Your schedule may be different.

Common side effects and what helps

• High cholesterol and fats in the blood. Your team will check your blood and may start a medicine to lower them.
• Swelling in the legs, feet, or hands. Raise your legs when sitting.
• Numbness, tingling, or pain in the hands or feet. Be careful with hot water and sharp objects.
• Changes in mood, memory, or thinking, or trouble sleeping. Tell your team, since a dose change may help.
• Weight gain. Healthy meals and regular activity can help.
• Feeling tired. Rest when you need to and take short walks when you can.
• Joint pain or diarrhea. Tell your team if it bothers you.

Call your care team right away if you have

• Confusion, feeling very sad or anxious, seeing or hearing things that are not there, or changes in speech
• Thoughts of hurting yourself
• Slow heartbeat, dizziness, or fainting
• New or worse cough, shortness of breath, or chest pain
• Bad headache, or blood pressure higher than your team told you to expect
• Feeling very thirsty, peeing a lot, or other signs of high blood sugar

Before you start, tell your team

• If you have a history of depression, anxiety, or other mental health conditions
• If you have high cholesterol, diabetes, high blood pressure, or heart rhythm problems
• If you use hormonal birth control, since this medicine can make it work less well
• If you are pregnant, may become pregnant, or are breastfeeding
• All the medicines, vitamins, and herbal products you take, since some can change how this medicine works

Good to know

• It can affect mood, thinking, and speech. Family members can help by watching for changes.
• It often raises cholesterol and other blood fats. You will have blood tests and may need medicine for this.
• It can slow the heart's electrical signals. You may have an ECG (a heart tracing).
• You will have checks of your blood pressure and blood sugar.
• It should not be taken with the antibiotic rifampin, which can cause serious liver damage.

At home

• Take it at about the same time each day.
• Swallow the pills whole with water. Do not crush, chew, or split them unless your team says it is OK.
• If you miss a dose or throw up after a dose, ask your team what to do. Do not take an extra dose on your own.
• Store the pills at room temperature in their original container, away from children and pets.
• Wash your hands after touching the pills. Ask your team if others in your home should take special care.

Questions to ask

• How long will I take this medicine?
• What tests will I need, and how often?
• Are any of my other medicines, foods, or supplements a problem with this medicine?
• What should I do if I miss a dose?
• Which side effects should I call you about right away, and which can wait?

Side effect guides

• Fatigue (tiredness)
• Diarrhea
• Neuropathy (numbness and tingling)
• Sleep problems
• Cognitive changes (chemo brain)
• Pain

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.