Drug interactions
Aripiprazole + Lopinavir
Severity: Major
Aripiprazole and Lopinavir: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Lopinavir boosted with ritonavir inhibits CYP3A4 and can raise aripiprazole exposure. Both drugs have some QT effect, so the combination may add to arrhythmia risk.
What this interaction means in plain words
Aripiprazole and Lopinavir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Aripiprazole belongs to Central Nervous System; Lopinavir belongs to Anti Virals.
Why it happens
CYP3A4 inhibition by ritonavir-boosted lopinavir reduces aripiprazole metabolism, with additive QT effects.
What to do
Reduce the aripiprazole dose to about half when a strong CYP3A4 inhibitor is started, and monitor for adverse effects. Check ECG and electrolytes if other QT risk factors are present.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Abilify 1 mg/mL Oral Solution - SmPC sections 4.3/4.5 (class statement: HIV protease inhibitors; "Other strong inhibitors of CYP3A4, such as itraconazole and HIV protease inhibitors may be expected to have similar effects and similar dose reductions should t") — electronic medicines compendium (UK SmPC)
Other interactions of Aripiprazole
- Aripiprazole + Pimozide Contraindicated
- Aripiprazole + Thioridazine Contraindicated
- Amisulpride + Aripiprazole Major
- Aripiprazole + Arsenic trioxide Major
- Aripiprazole + Calcium / magnesium / potassium / sodium oxybates Major
- Aripiprazole + Carbamazepine Major
Other interactions of Lopinavir
- Alfuzosin + Lopinavir Contraindicated
- Avanafil + Lopinavir Contraindicated
- Cisapride + Lopinavir Contraindicated
- Dronedarone + Lopinavir Contraindicated
- Eletriptan + Lopinavir Contraindicated
- Eplerenone + Lopinavir Contraindicated
Frequently asked questions
Can I take Aripiprazole with Lopinavir?
MediHelp rates the interaction as major. Aripiprazole and Lopinavir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Lopinavir boosted with ritonavir inhibits CYP3A4 and can raise aripiprazole exposure. Both drugs have some QT effect, so the combination may add to arrhythmia risk.
How serious is the interaction between Aripiprazole and Lopinavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the aripiprazole dose to about half when a strong CYP3A4 inhibitor is started, and monitor for adverse effects. Check ECG and electrolytes if other QT risk factors are present.
What other medicines interact with Aripiprazole?
MediHelp also lists interactions of Aripiprazole with, for example, Pimozide, Thioridazine, Amisulpride. The full list is on the Aripiprazole page.
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