Drug interactions
Hydroxyzine + Lopinavir
Severity: Major
Hydroxyzine 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
Hydroxyzine and lopinavir/ritonavir both have QT-prolonging potential, and combining them may increase the risk of torsades de pointes. Ritonavir-mediated CYP3A4 inhibition may also raise hydroxyzine exposure.
What this interaction means in plain words
Hydroxyzine 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.
Hydroxyzine belongs to Respiratory; Lopinavir belongs to Anti Virals.
Why it happens
Additive QT prolongation, with possible increased hydroxyzine exposure from CYP3A4 inhibition by ritonavir.
What to do
Avoid the combination where possible and choose a non-QT-prolonging antihistamine. If it cannot be avoided, use the lowest hydroxyzine dose, check a baseline ECG, and monitor the QTc and electrolytes.
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 Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine 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 Hydroxyzine with Lopinavir?
MediHelp rates the interaction as major. Hydroxyzine 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. Hydroxyzine and lopinavir/ritonavir both have QT-prolonging potential, and combining them may increase the risk of torsades de pointes. Ritonavir-mediated CYP3A4 inhibition may also raise hydroxyzine exposure.
How serious is the interaction between Hydroxyzine 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 non-QT-prolonging antihistamine. If it cannot be avoided, use the lowest hydroxyzine dose, check a baseline ECG, and monitor the QTc and electrolytes.
What other medicines interact with Hydroxyzine?
MediHelp also lists interactions of Hydroxyzine with, for example, Droperidol, Pimozide, Thioridazine. The full list is on the Hydroxyzine page.
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