Types of Foods to Be Cautious of or Avoid While Taking Lorlatinib

Lorlatinib is a targeted therapy indicated for the treatment of ALK-positive non-small cell lung cancer (NSCLC). Its dietary restrictions primarily aim to avoid foods that may interfere with drug metabolism, exacerbate side effects, or compromise therapeutic efficacy. While there is no well-defined classification of "top 10 forbidden foods" in clinical medicine, the following key dietary principles should be strictly observed:

Types of Foods to Be Cautious of or Avoid While Taking Lorlatinib

Grapefruits and Citrus Fruits

Grapefruits, pomelos, and other related fruits may inhibit the activity of CYP3A4 enzymes in the liver. This inhibition can elevate the plasma concentration of lorlatinib, thereby increasing the risk of adverse reactions such as liver injury and cardiac arrhythmias. Consumption of relevant fruit juices or pulp is strongly discouraged throughout the entire course of medication.

High-Fat, High-Calorie Foods

High-fat diets can delay drug absorption and undermine the stability of therapeutic effects. During the treatment period, it is advisable to reduce the intake of fried foods, fatty meats, cream cakes, and similar items, and instead opt for light, easily digestible proteins and vegetables.

Alcoholic Beverages

Alcohol may impose an additional burden on liver metabolism. Concurrent use with lorlatinib could induce or aggravate adverse reactions including liver damage, nausea, and headaches. Strict abstinence from alcohol is mandatory.

High-Salt Foods

Lorlatinib may cause edema or hypertension. High-salt foods such as pickled products, processed meats (e.g., ham, sausages), and sauces can exacerbate these side effects, so their consumption should be limited.

Caffeinated Beverages

Coffee, strong tea, energy drinks, and other caffeinated products may worsen medication-induced insomnia, palpitations, or gastrointestinal discomfort. It is recommended to control the intake of such beverages.

Important Dietary Considerations

Herbal Supplements and Dietary Additives

Herbal products like St. John's Wort, ginseng, and ginkgo biloba may interfere with the activity of drug-metabolizing enzymes, potentially affecting therapeutic efficacy or increasing toxicity. Patients must inform their physicians of any supplements they are taking prior to starting lorlatinib treatment.

Dairy Products and Calcium-Fortified Foods

High-calcium foods (e.g., milk, cheese) can form chelates with lorlatinib, reducing its absorption rate. It is recommended to avoid consuming large quantities of these foods 2 hours before or after taking the medication.

Raw, Cold or Undercooked Foods

Patients with compromised immune function should avoid raw fish, soft-boiled eggs, and similar items to minimize the risk of infection.

Individualized Adjustments and Physician Consultation

No absolute dietary prohibitions, but monitor bodily responses: If a particular food triggers significant discomfort (e.g., diarrhea, vomiting), patients should document the occurrence and promptly report it to their treating physician.

Timing interval between medication and meals: Lorlatinib is generally recommended to be taken on an empty stomach (1 hour before or 2 hours after meals). Specific administration instructions must be followed in accordance with the physician’s advice.

Fluid intake: Adequate daily water consumption helps promote metabolism, but excessive intake should be avoided to prevent edema.

The core objective of dietary restrictions for lorlatinib is to minimize drug interactions and reduce the risk of side effects. These restrictions should be adjusted based on individual patient conditions rather than adhering to a rigid, one-size-fits-all list. During the treatment period, patients should undergo regular monitoring of liver function, blood pressure, and other relevant indicators, and maintain close communication with their attending physicians to develop a personalized dietary plan.