Drug interactions
Hydrocortisone + Lopinavir
Severity: Moderate
Hydrocortisone 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 is boosted with ritonavir, which strongly inhibits CYP3A4, so hydrocortisone exposure is expected to increase rather than decrease lopinavir levels. Raised corticosteroid levels can cause Cushingoid effects and adrenal suppression with prolonged use. Any effect of hydrocortisone on lopinavir is minor.
What this interaction means in plain words
Hydrocortisone 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.
Hydrocortisone belongs to Endocrine; Lopinavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted lopinavir inhibits CYP3A4 and reduces hydrocortisone clearance, and hydrocortisone may weakly induce CYP3A4.
What to do
Monitor for corticosteroid excess during prolonged co-use and use the lowest effective hydrocortisone dose. Monitor HIV viral load if the combination is used long term.
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 Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone 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 Hydrocortisone with Lopinavir?
MediHelp rates the interaction as moderate. Hydrocortisone 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 is boosted with ritonavir, which strongly inhibits CYP3A4, so hydrocortisone exposure is expected to increase rather than decrease lopinavir levels. Raised corticosteroid levels can cause Cushingoid effects and adrenal suppression with prolonged use. Any effect of hydrocortisone on lopinavir is minor.
How serious is the interaction between Hydrocortisone 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: Monitor for corticosteroid excess during prolonged co-use and use the lowest effective hydrocortisone dose. Monitor HIV viral load if the combination is used long term.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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