Drug interactions
Dexamethasone + Lopinavir
Severity: Moderate
Dexamethasone and Lopinavir: moderate 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 and can markedly raise dexamethasone exposure. Dexamethasone in turn may induce CYP3A4 and lower lopinavir concentrations, risking reduced antiviral efficacy.
What this interaction means in plain words
Dexamethasone and Lopinavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Dexamethasone belongs to Endocrine; Lopinavir belongs to Anti Virals.
Why it happens
Bidirectional CYP3A4 effects: inhibition of dexamethasone metabolism by lopinavir/ritonavir and induction of lopinavir metabolism by dexamethasone.
What to do
Use the lowest effective dexamethasone dose for the shortest time and monitor for steroid toxicity. Monitor HIV viral load, and consider lopinavir levels if prolonged dexamethasone is required.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine Contraindicated
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 Dexamethasone with Lopinavir?
MediHelp rates the interaction as moderate. Dexamethasone and Lopinavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lopinavir boosted with ritonavir strongly inhibits CYP3A4 and can markedly raise dexamethasone exposure. Dexamethasone in turn may induce CYP3A4 and lower lopinavir concentrations, risking reduced antiviral efficacy.
How serious is the interaction between Dexamethasone and Lopinavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective dexamethasone dose for the shortest time and monitor for steroid toxicity. Monitor HIV viral load, and consider lopinavir levels if prolonged dexamethasone is required.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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