Drug interactions
Cariprazine + Lopinavir
Severity: Major
Cariprazine and Lopinavir: major interaction.
Last updated
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, strongly inhibits CYP3A4, the main route of cariprazine and its active metabolites. Exposure to cariprazine can rise substantially, increasing the risk of akathisia, parkinsonism, sedation and orthostatic hypotension, and the effect lasts a long time because of the long half-lives of the active metabolites.
What this interaction means in plain words
Cariprazine 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.
Cariprazine belongs to Central Nervous System; Lopinavir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4-mediated metabolism of cariprazine and its active metabolites raises their plasma concentrations.
What to do
Reduce the cariprazine dose as directed in labeling when a strong CYP3A4 inhibitor is started (about half the usual dose), and monitor for extrapyramidal and sedative adverse effects. Re-adjust the dose after the inhibitor is stopped, allowing for the long washout.
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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Other interactions of Cariprazine
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 Cariprazine with Lopinavir?
MediHelp rates the interaction as major. Cariprazine 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, strongly inhibits CYP3A4, the main route of cariprazine and its active metabolites. Exposure to cariprazine can rise substantially, increasing the risk of akathisia, parkinsonism, sedation and orthostatic hypotension, and the effect lasts a long time because of the long half-lives of the active metabolites.
How serious is the interaction between Cariprazine 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 cariprazine dose as directed in labeling when a strong CYP3A4 inhibitor is started (about half the usual dose), and monitor for extrapyramidal and sedative adverse effects. Re-adjust the dose after the inhibitor is stopped, allowing for the long washout.
What other medicines interact with Cariprazine?
MediHelp also lists interactions of Cariprazine with, for example, Alfentanil, Amisulpride, Amobarbital. The full list is on the Cariprazine page.
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