Lopinavir drug interactions | Litt's Drug Eruption and Reaction Database

Lopinavir

TRADE NAMES: Aluvira; Kaletra (AbbVie)
INDICATIONS: HIV-1 infected children above the age of 2 years and adults, in combination with other antiretroviral agents
CLASS: Antiretroviral, Covid-19 putative drug, HIV-1 protease inhibitor
HALF-LIFE: 5–6 hours

CLINICALLY IMPORTANT, POTENTIALLY HAZARDOUS INTERACTIONS WITH:

Abacavir, Alfuzosin, Amiodarone, Amprenavir, Aripiprazole, Artemether/Lumefantrine, Atazanavir, Atorvastatin, Atovaquone, Bepridil, Bosentan, Brigatinib, Bupropion, Cabozantinib, Carbamazepine, Chlorpheniramine, Cisapride, Clarithromycin, Colchicine, Copanlisib, Cyclosporine, Darifenacin, Darunavir, Dasatinib, Delavirdine, Dexamethasone, Didanosine, Digoxin, Disulfiram, Efavirenz, Elbasvir & Grazoprevir, Eltrombopag, Eluxadoline, Ergotamine, Estradiol, Felodipine, Fentanyl, Flecainide, Fluticasone Propionate, Fosamprenavir, Glecaprevir & Pibrentasvir, Indinavir, Itraconazole, Ketoconazole, Lidocaine, Lidocaine, Lomitapide, Lovastatin, Maraviroc, Methadone, Methylergonovine, Metronidazole, Midazolam, Midostaurin, Mifepristone, Nelfinavir, Neratinib, Nevirapine, Nicardipine, Nifedipine, Nilotinib, Olaparib, Ombitasvir/Paritaprevir/Ritonavir, Palbociclib, Phenobarbital, Phenytoin, Pimozide, Pitavastatin, Ponatinib, Primidone, Quinidine, Ranolazine, Ribociclib, Rifabutin, Rifampin, Rilpivirine, Rivaroxaban, Rosuvastatin, Ruxolitinib, Salmeterol, Saquinavir, Sildenafil, Simeprevir, Simvastatin, Sirolimus, Sofosbuvir/Velpatasvir/Voxilaprevir, St John's Wort, Tacrolimus, Tadalafil, Telithromycin, Tenofovir Disoproxil, Tipranavir, Tolterodine, Trazodone, Triazolam, Vardenafil, Venetoclax, Vinblastine, Vincristine, Voriconazole, Warfarin, Zidovudine

PREGNANCY CATEGORY: C

Under investigation for treating COVID-19

See adverse reactions attributed to class:

Antiretroviral

Covid-19 putative drug

HIV-1 protease inhibitor

NOTE

Kaletra is lopinavir and ritonavir.

Skin

Acneiform eruption / acneiform dermatitis / acneiform rash <10%

(package insert)

Acute generalized exanthematous pustulosis (AGEP)

(2005): Ghosn J+, Clin Infect Dis 41(9), 1360

Dermatitis

(2005): Calista D, Eur J Dermatol 15(2), 97 (with ritonavir)

Hypersensitivity

(2006): Manfredi R+, AIDS 20(18), 2399

Jaundice

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, ritonavir and zidovudine)

Lipodystrophy <10%

(package insert)

Rash <10%

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, ritonavir and zidovudine)

(2014): Cai J+, Chin Med J (Engl) 127(14), 263269% (with lamivudine, ritonavir and zidovudine)

(2014): Santini-Oliveira M+, Expert Opin Drug Saf 13(12), 1623 [REVIEW] (with ritonavir)

(2008): Borras-Blasco J+, J Antimicrob Chemother 62(5), 879 (with ritonavir)

(2005): Calista D, Eur J Dermatol 15(2), 97 (with ritonavir)

Skin toxicity / toxicity

(2014): Martin-Carbonero L+, HIV Clin Trials 15(2), 576%

Hair

Alopecia / hair loss

(2007): Borras-Blasco+, Pharmacotherapy 27(8), 1215

(2007): Chrysos G+, J Drugs Dermatol 6(7), 742

(2003): Bongiovanni M+, Dermatol Online J 9(5), 28 (with ritonavir)

Alopecia areata

(2014): Kim HS+, Infect Chemother 46(2), 103 (with ritonavir)

Nails

Nail pigmentation

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, ritonavir and zidovudine)

Mucosal

Oropharyngeal pain

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, ritonavir and zidovudine)

Sialorrhea (ptyalism; hypersalivation)

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, ritonavir and zidovudine)

Cardiovascular

Arrhythmias

(2009): Chaubey SK+, Sex Health 6(3), 254

Cardiotoxicity

(2009): McArthur MA+, Pediatr Infect Dis J 28(12), 1127 (in neonatal twins / with ritonavir)

Sick sinus syndrome

(2013): Sasaki S+, Kansenshogaku Zasshi (Japanese) 87(5), 613 (2 cases) (with ritonavir)

Torsades de pointes

(2010): Poluzzi E+, Drug Saf 33 (4), 303

Vasoconstriction

(2014): Ferry FR+, Rev Inst Med Trop Sao Paulo 56(3), 265 (with ergotamine and ritonavir)

Central Nervous System

Anorexia

(2015): Tetteh RA+, BMC Public Health 15(1), 5736% (with lamivudine, ritonavir and zidovudine)

Fever (pyrexia)

(2015): Tetteh RA+, BMC Public Health 15(1), 5736% (with lamivudine, ritonavir and zidovudine)

Headache

(2015): Tetteh RA+, BMC Public Health 15(1), 57310% (with lamivudine, ritonavir and zidovudine)

Insomnia

(2015): Tetteh RA+, BMC Public Health 15(1), 5734% (with lamivudine, ritonavir and zidovudine)

Restlessness

(2015): Tetteh RA+, BMC Public Health 15(1), 5734% (with lamivudine, ritonavir and zidovudine)

Somnolence (drowsiness)

(2015): Tetteh RA+, BMC Public Health 15(1), 5736% (with lamivudine, ritonavir and zidovudine)

Vertigo / dizziness

(2015): Rattanapunya S+, Malar J 14(1), 400 (with artesunate, mefloquine and ritonavir)

(2015): Tetteh RA+, BMC Public Health 15(1), 5738% (with lamivudine, ritonavir and zidovudine)

Endocrine/Metabolic

Appetite decreased

(2015): Tetteh RA+, BMC Public Health 15(1), 57310% (with lamivudine, ritonavir and zidovudine)

Cushing's syndrome

(2007): Bhumbra NA+, Ann Pharmacother 41(7), 1306 (with fluticasone and ritonavir)

Diabetes mellitus

(2014): Santini-Oliveira M+, Expert Opin Drug Saf 13(12), 1623 [REVIEW] (with ritonavir)

Hyponatremia

(2007): Roberts MT+, Int J Infect Dis 11(1), 83-4

Inappropriate secretion of antidiuretic hormone (SIADH)

(2010): Yeong MM+, Pediatr Infect Dis J 29 (7), 678

Miscarriage

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, ritonavir and zidovudine)

Gastrointestinal/Hepatic

Abdominal pain

(2015): Tetteh RA+, BMC Public Health 15(1), 57314% (with lamivudine, ritonavir and zidovudine)

Diarrhea >10%

(2015): Tetteh RA+, BMC Public Health 15(1), 57365% (with lamivudine, ritonavir and zidovudine)

(2014): Clumeck N+, AIDS 28(8), 114315% (with ritonavir)

(2013): Orkin C+, HIV Med 14(1), 4911% (with ritonavir)

(2012): Wegzyn CM+, J Int Assoc Physicians AIDS Care (Chic) 11(4), 25216% (with ritonavir)

(2009): Nunes EP+, HIV Clin Trials 10 (6), 368

Flatulence <10%

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, ritonavir and zidovudine)

Gastritis / pangastritis / gastric irritation

(2014): Cahn P+, Lancet Infect Dis 14(7), 572 (serious / 1 case) (with lamivudine and ritonavir)

Gastrointestinal disorder / discomfort

(2020): Chouchana L+, Ther Drug Monit Nov, Online ahead of print (with ritonavir)

Hepatic (liver) disorder / hepatic (liver) dysfunction

(2020): Chouchana L+, Ther Drug Monit Nov, Online ahead of print (with ritonavir)

Hepatotoxicity / liver injury / acute liver injury / drug-induced liver injury (DILI)

(2014): Cai J+, Chin Med J (Engl) 127(14), 263239% (with lamivudine, ritonavir and zidovudine)

Nausea <10%

(2015): Rattanapunya S+, Malar J 14(1), 400 (with artesunate, mefloquine and ritonavir)

(2015): Tetteh RA+, BMC Public Health 15(1), 57371% (with lamivudine, ritonavir and zidovudine)

(2014): Clumeck N+, AIDS 28(8), 114319% (with ritonavir)

(2010): Zajdenverg R+, J Acquir Immune Defic Syndr 54 (2), 143

Pancreatitis / acute pancreatitis

(2008): Anand H+, J Postgrad Med 54(2), 153

(2008): Bhargava P, J Postgrad Med 54(3), 241

Vomiting <10%

(2015): Rattanapunya S+, Malar J 14(1), 400 (with artesunate, mefloquine and ritonavir)

(2015): Tetteh RA+, BMC Public Health 15(1), 57335% (with lamivudine, ritonavir and zidovudine)

(2014): Clumeck N+, AIDS 28(8), 114313% (with ritonavir)

Hematologic

Bleeding

(2015): Tetteh RA+, BMC Public Health 15(1), 573 (with lamivudine, ritonavir and zidovudine)

Neuromuscular/Skeletal

Asthenia / fatigue <10%

(2015): Tetteh RA+, BMC Public Health 15(1), 57310–27% (with lamivudine, ritonavir and zidovudine)

(2014): Cai J+, Chin Med J (Engl) 127(14), 263289% (with lamivudine, ritonavir and zidovudine)

Neck pain

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, ritonavir and zidovudine)

Osteomalacia

(2013): Lucey JM+, BMJ Case Rep Jul, Epub (with emtricitabine, ritonavir and tenofovir)

Tendinopathy/Tendon rupture

(2014): Cresswell FV+, Int J STD AIDS 25(11), 833 (with ritonavir)

Renal

Fanconi syndrome

(2013): Lucey JM+, BMJ Case Rep Jul, Epub (with emtricitabine, ritonavir and tenofovir)

Nephrolithiasis

(2014): Izzedine H+, Clin Kidney J 7(2), 121 [REVIEW]

(2004): Doco-Lecompte T+, AIDS 18(4), 705 (with ritonavir)

Nephrotoxicity / kidney injury / acute kidney injury (AKI) / drug-induced kidney injury

(2021): Tang H+, Int J Clin Pharm Jul, Online ahead of print [REVIEW] (with ritonavir)

(2015): Chughlay MF+, AIDS 29(4), 503 (with ritonavir)

(2014): Santini-Oliveira M+, Expert Opin Drug Saf 13(12), 1623 [REVIEW] (with ritonavir)

Renal failure

(2014): Krishna MM+, Indian J Pharmacol 46(2), 230 (delayed / with emtricitabine, ritonavir and tenofovir)

Other

Adverse effects

(2014): Cai J+, Chin Med J (Engl) 127(14), 2632 (gastrointestinal / with lamivudine, ritonavir and zidovudine)

Adverse reactions attributed to entire drug class Antiretroviral

Hematologic

Hematological adverse effect

(2019): Oumar AA+, Int J Basic Clin Pharmacol 8(5), 83115%

Ocular

Optic neuropathy

(2013): Wang MY+, J Neuroophthalmol 33(2), 172 [REVIEW]

Other

Adverse effects

(2019): Oumar AA+, Int J Basic Clin Pharmacol 8(5), 83142%

(2014): Lorio M+, J Int Assoc Provid AIDS Care 13(5), 4666%

Adverse reactions attributed to entire drug class Covid-19 putative drug

Skin

Cutaneous adverse reaction / severe cutaneous adverse drug reaction (SCAR)

(2020): Tursen U+, Dermatol Ther May, Epub ahead of print [REVIEW]

Cardiovascular

Cardiovascular adverse effect

(2020): Carpenter A+, Front Cardiovasc Med 7, 85 [REVIEW]

(2020): Giudicessi JR+, Mayo Clin Proc May, Online ahead of print [REVIEW]

(2020): Naksuk N+, Eur Heart J Acute Cardiovasc Care May, Epub ahead of print [REVIEW]

(2020): Sarayani A+, Res Social Adm Pharm Apr, Epub ahead of print [REVIEW]

(2020): Zhang D+, Zhongguo Zhong Yao Za Zhi (Chinese) 45(10), 2275-2286 [REVIEW]

Central Nervous System

Neuropsychiatric / neuropsychological adverse effect

(2021): Borah P+, Front Mol Biosci 8, 627723

(2020): García CAC+, Gen Hosp Psychiatry Jun, Online ahead of print [REVIEW]

Gastrointestinal/Hepatic

Gastrointestinal disorder / discomfort

(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print23%

Hepatic (liver) disorder / hepatic (liver) dysfunction

(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print14%

Hematologic

Thrombocytopenia

(2020): Nham E+, Infect Chemother Apr, Epub ahead of print

Other

Adverse effects

(2021): Bérard A+, PLoS One 16(5), e0251746 [REVIEW] (in pregnancy)

(2021): Cheng Q+, Aging (Albany NY) Sep, Online ahead of print [REVIEW]

(2021): Cruciani F+, Recenti Prog Med 112(3), 195-206 [REVIEW]

(2021): Ommati MM+, J Biochem Mol Toxicol May, Online ahead of print [REVIEW]

(2021): Qiu R+, Medicine (Baltimore) 100(16), e25532 [REVIEW]

(2021): Wu SS+, Chin Med J (Engl) Jul, Online ahead of print [REVIEW]

(2020): Favilli A+, J Matern Fetal Neonatal Med Jun, Online ahead of print [REVIEW]

(2020): Griffiths G+, Trials 21(1), 544

(2020): Patil VM+, Life Sci May, Epub ahead of print [REVIEW]

(2020): Rhodes NJ+, medRxiv Jun, Preprint

(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print38%

(2020): Svensson M, Lakartidningen (Swedish) Apr, 117

(2020): Wen CY+, Zhonghua Nei Ke Za Zhi (Chinese) May, Epub ahead of print

(2020): Zekarias A+, Drug Saf Sep, Online ahead of print [REVIEW]

(2020): Zhong H+, Pharmacol Res Apr, Epub ahead of print [REVIEW]

Adverse reactions attributed to entire drug class HIV-1 protease inhibitor

Skin

Eczema

(2015): Descamps V+, Br J Dermatol 173(1), 311

Xerosis

(2015): Descamps V+, Br J Dermatol 173(1), 311

Page last updated 08/02/2021

Symbol key

Incidence

<1%
1-5%
5-10%
10-15%
15-20%
20-30%
>30%

Seriousness

Hospitalization possible
Life threatening
Fatal

Warnings in other populations

Breast feeding
Geriatric
Pediatric

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