Drug interactions
Hydrocodone + Lopinavir
Severity: Major
Hydrocodone 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, given with ritonavir, inhibits CYP3A4 and can increase hydrocodone exposure. Opioid effects including respiratory depression and sedation may be intensified.
What this interaction means in plain words
Hydrocodone 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.
Hydrocodone belongs to Musculoskeletal; Lopinavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted lopinavir inhibits CYP3A4, slowing hydrocodone metabolism.
What to do
Start with a reduced hydrocodone dose and monitor for respiratory depression and sedation, titrating carefully. Reassess the opioid dose if the antiretroviral regimen changes.
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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone 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 Hydrocodone with Lopinavir?
MediHelp rates the interaction as major. Hydrocodone 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, given with ritonavir, inhibits CYP3A4 and can increase hydrocodone exposure. Opioid effects including respiratory depression and sedation may be intensified.
How serious is the interaction between Hydrocodone 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: Start with a reduced hydrocodone dose and monitor for respiratory depression and sedation, titrating carefully. Reassess the opioid dose if the antiretroviral regimen changes.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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