Drug interactions
Axitinib + Lopinavir
Severity: Major
Axitinib 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, which is given with ritonavir, strongly inhibits CYP3A4 and can increase axitinib levels. This raises the risk of axitinib toxicity.
What this interaction means in plain words
Axitinib 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.
Axitinib belongs to Oncology; Lopinavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted lopinavir inhibits CYP3A4-mediated axitinib metabolism.
What to do
Use an alternative antiretroviral if possible. If coadministered, reduce axitinib dose by about 50% and monitor blood pressure and tolerability.
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
- Axitinib 1 mg Film-coated Tablets - SmPC sections 4.3/4.5 (class statement: strong CYP3A4/5 inhibitors; "Co-administration of axitinib with strong CYP3A4/5 inhibitors (e.g. ketoconazole, itraconazole, clarithromycin, erythromycin, atazanavir, indinavir, nefazodone,") — electronic medicines compendium (UK SmPC)
Other interactions of Axitinib
- Amobarbital + Axitinib Major
- Apalutamide + Axitinib Major
- Atazanavir + Axitinib Major
- Axitinib + Carbamazepine Major
- Axitinib + Clarithromycin Major
- Axitinib + Cobicistat 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 Axitinib with Lopinavir?
MediHelp rates the interaction as major. Axitinib 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, which is given with ritonavir, strongly inhibits CYP3A4 and can increase axitinib levels. This raises the risk of axitinib toxicity.
How serious is the interaction between Axitinib 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: Use an alternative antiretroviral if possible. If coadministered, reduce axitinib dose by about 50% and monitor blood pressure and tolerability.
What other medicines interact with Axitinib?
MediHelp also lists interactions of Axitinib with, for example, Amobarbital, Apalutamide, Atazanavir. The full list is on the Axitinib page.
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