Lorbrena

(lorlatinib)
LORBRENA 25 MG Oral TabletLORBRENA 100 MG Oral Tablet
NO BOXED WARNING

Dosage & administration

Recommended dosage: 100 mg orally once daily.

Severe Renal Impairment: 75 mg orally once daily.

drug label

Lorbrena prescribing information

samples

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prior authorization

Lorbrena prior authorization resources

Most recent Lorbrena prior authorization forms

View By Payer
Verified: Feb 07, 2024Kaiser Foundation Health Plan - Chronic High-Dose Opioid Therapy Prior Authorization Form Washington
Verified: Feb 01, 2024Highmark BCBS Northeastern NY - Medical Injectable Specialty Drug Prior Authorization Form
Verified: Feb 01, 2024Highmark BCBS Northeastern NY - Outpatient Chemotherapy Prior Authorization Form (Medical Benefit)
Verified: Feb 01, 2024Highmark BCBS Northeastern NY - Specialty Drug Prior Authorization Form
Verified: Feb 01, 2024Highmark BCBS Northeastern NY - Non-Formulary Drug Coverage Prior Authorization Form

Most recent state uniform prior authorization forms

Verified: Jan 28, 2024Oregon - Uniform Prior Authorization Form
Verified: Jan 28, 2024Colorado - Uniform Prior Authorization Form
Verified: Jan 28, 2024Michigan - Uniform Prior Authorization Form
Verified: Jan 28, 2024Hawaii - Uniform Prior Authorization Form
Verified: Jan 28, 2024Minnesota - Uniform Prior Authorization Form
Verified: Jan 28, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Jan 28, 2024New Mexico - Uniform Prior Authorization Form
Verified: Jan 28, 2024Texas - Uniform Prior Authorization Form
Verified: Jan 28, 2024Louisiana - Uniform Prior Authorization Form
Verified: Jan 28, 2024Arizona - Uniform Prior Authorization Form
Verified: Jan 28, 2024Indiana - Uniform Prior Authorization Form
Verified: Jan 28, 2024Illinois - Uniform Prior Authorization Form
Complete Letter of Medical Necessity
Coverage Authorization Appeals
Formulary Exception Letter
PA Checklist
Appeals Checklist
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Benefits investigation

Pfizer Oncology Together Form
Pfizer Oncology Together Form: Spanish
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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information
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pharmacy

Lorbrena preferred pharmacy

Pharmacy List

Financial Assistance

Financial Assistance Programs

Lorbrena retails for $250 per dose without insurance or financial assistance.Depending on your patient's insurance situation and other eligibility criteria, they may be able to get Lorbrena for significantly less. Review the program information below to determine what program can offer your patient the most benefits.
CoPay Card Program$0 Co Pay
Available for
commercial
Program Details
  • $250 for Tablet
  • Program Expires 12/31/2024
  • $25000 Annual Cap
Forms
Enroll in Patient Savings Program
HCP Office: Access & Print Co-Pay Card
Foundation ProgramFirst dose for $0
Available for
medicare
uninsured
Eligibility requirements
  • Uninsured
  • Medicare
  • Medicaid
  • Underinsured
  • Household annual adjusted gross income <= 300% FPL.
Forms
Pfizer Oncology Together Form
Pfizer Oncology Together Form: Spanish
Pfizer Patient Assistance Program

PubMed™ | Lorbrena

Lorbrena PubMed™ News

patient education

Lorbrena patient education

To share resource; ask patient to:
1.Pull out phone
2.Open camera
3.Scan QR code with camera
4.Tap link

Patient toolkit

Pfizer Oncology Patient Access Guide
ASK PATIENT TO:
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Scan QR Code & Tap Link
Pfizer Oncology Patient Access Guide - Spanish
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About Lorbrena
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View How to Take Lorbrena
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Patient Stories
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Patient Resources
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Side Effects
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Patient Brochure
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Patient Guide to Common Side Effects
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What to Expect Brochure
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Doctor Discussion Guide
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Patient Journal
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7 Tips from Care Partners to Help Navigate Your Loved One’s Lung Cancer
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people also ask

Lorbrena FAQs

Is LORBRENA safe to use during pregnancy?Based on findings from animal studies and its mechanism of action, LORBRENA can cause embryo-fetal harm when administered to a pregnant woman. There are no available data on LORBRENA use in pregnant women. Administration of lorlatinib to pregnant rats and rabbits during the period of organogenesis resulted in malformations, increased post-implantation loss, and abortion at maternal exposures that were equal to or less than the human exposure at the recommended dose of 100 mg once daily based on AUC. Therefore, it is advised to inform pregnant women of the potential risk to a fetus.
Is it safe to breastfeed while using LORBRENA?There are no data on the presence of lorlatinib or its metabolites in either human or animal milk or its effects on the breastfed infant or on milk production. Because of the potential for serious adverse reactions in breastfed infants, women are instructed not to breastfeed during treatment with LORBRENA and for 7 days after the final dose.
What precautions should be taken by females and males of reproductive potential?Before initiating LORBRENA, pregnancy status in females of reproductive potential should be verified. LORBRENA can cause embryo-fetal harm when administered to a pregnant woman, so female patients of reproductive potential are advised to use effective non-hormonal contraception during treatment with LORBRENA and for at least 6 months after the final dose. A non-hormonal method of contraception should be used, as LORBRENA can render hormonal contraceptives ineffective. For males with female partners of reproductive potential, effective contraception should be used during treatment with LORBRENA and for at least 3 months after the final dose, based on genotoxicity findings. LORBRENA may transiently impair male fertility, according to findings from animal studies.
Is LORBRENA safe for pediatric use?The safety and effectiveness of LORBRENA in pediatric patients have not been established.
Is LORBRENA safe for geriatric use?No clinically important differences in safety or efficacy were observed between patients aged 65 years or older and younger patients in studies B7461001 and B7461006. However, caution is advised when treating elderly patients, as they may be more sensitive to the effects of LORBRENA.
Is LORBRENA safe for patients with hepatic impairment?No dose adjustment is recommended for patients with mild hepatic impairment. The recommended dose of LORBRENA has not been established for patients with moderate or severe hepatic impairment.
What is renal impairment?Renal impairment refers to a condition where the kidneys are not functioning properly, leading to a decrease in their ability to filter waste products and excess fluids from the body.
What is CLcr?CLcr stands for creatinine clearance, which is a measure of kidney function. It is estimated using the Cockcroft-Gault equation based on a person's age, weight, and serum creatinine level.
Who should have a reduced dose of LORBRENA due to renal impairment?Patients with severe renal impairment, which is defined as a CLcr of 15 to less than 30 mL/min, should have a reduced dose of LORBRENA when it is administered.
Is a dose adjustment necessary for patients with mild or moderate renal impairment?No, a dose adjustment is not recommended for patients with mild or moderate renal impairment, which is defined as a CLcr of 30 to 89 mL/min.
Where can I find more information on dosing for patients with renal impairment?More information on dosing for patients with renal impairment can be found in the 'Dosage and Administration' section (2.8) and the 'Clinical Pharmacology' section (12.3) of the LORBRENA prescribing information.
FAQ Data Source