Drug interactions
Donepezil + Lopinavir
Severity: Major
Donepezil 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
Both drugs can prolong the QT interval, so combined use may raise the risk of torsades de pointes. Lopinavir/ritonavir is also a CYP3A4 inhibitor that may increase donepezil exposure.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Lopinavir belongs to Anti Virals.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition by the ritonavir-boosted lopinavir that may raise donepezil levels.
What to do
Obtain a baseline ECG and monitor QTc and heart rate. Watch for cholinergic effects such as bradycardia and consider an alternative if QTc rises.
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 Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil 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 Donepezil with Lopinavir?
MediHelp rates the interaction as major. Donepezil 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. Both drugs can prolong the QT interval, so combined use may raise the risk of torsades de pointes. Lopinavir/ritonavir is also a CYP3A4 inhibitor that may increase donepezil exposure.
How serious is the interaction between Donepezil 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: Obtain a baseline ECG and monitor QTc and heart rate. Watch for cholinergic effects such as bradycardia and consider an alternative if QTc rises.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
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