Drug interactions
Enzalutamide + Lopinavir
Severity: Major
Enzalutamide and Lopinavir: major interaction.
Last updated Sources: EMA 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
Enzalutamide, a strong CYP3A4 inducer, lowers lopinavir concentrations, which can lead to loss of virologic suppression and resistance. Ritonavir in the lopinavir product may increase enzalutamide levels, raising the risk of adverse effects.
What this interaction means in plain words
Enzalutamide 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.
Enzalutamide belongs to Endocrine; Lopinavir belongs to Anti Virals.
Why it happens
Enzalutamide induces CYP3A4 lowering lopinavir; ritonavir co-formulated with lopinavir inhibits CYP3A4 and may raise enzalutamide.
What to do
Avoid the combination where possible and choose a regimen not reliant on CYP3A4. If used, monitor HIV RNA and consider reducing the enzalutamide dose.
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
Other interactions of Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir 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 Enzalutamide with Lopinavir?
MediHelp rates the interaction as major. Enzalutamide 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. Enzalutamide, a strong CYP3A4 inducer, lowers lopinavir concentrations, which can lead to loss of virologic suppression and resistance. Ritonavir in the lopinavir product may increase enzalutamide levels, raising the risk of adverse effects.
How serious is the interaction between Enzalutamide 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: Avoid the combination where possible and choose a regimen not reliant on CYP3A4. If used, monitor HIV RNA and consider reducing the enzalutamide dose.
What other medicines interact with Enzalutamide?
MediHelp also lists interactions of Enzalutamide with, for example, Doravirine, Elbasvir / grazoprevir, Ensitrelvir. The full list is on the Enzalutamide page.
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