Drug interactions
Imatinib + Lopinavir
Severity: Major
Imatinib 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 is co-formulated with ritonavir, a strong CYP3A4 inhibitor, and can raise imatinib plasma concentrations. Higher imatinib exposure may increase fluid retention, myelosuppression, hepatotoxicity and gastrointestinal effects.
What this interaction means in plain words
Imatinib 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.
Imatinib belongs to Oncology; Lopinavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted lopinavir inhibits CYP3A4, the main enzyme that metabolizes imatinib.
What to do
Prefer an antiretroviral regimen without a strong CYP3A4 inhibitor. If the combination is necessary, consider reducing the imatinib dose and monitor blood counts, liver enzymes and fluid status.
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 Imatinib
- Imatinib + Lomitapide Contraindicated
- Imatinib + Lonafarnib Contraindicated
- Amobarbital + Imatinib Major
- Apalutamide + Imatinib Major
- Avapritinib + Imatinib Major
- Benzhydrocodone / acetaminophen + Imatinib 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 Imatinib with Lopinavir?
MediHelp rates the interaction as major. Imatinib 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 is co-formulated with ritonavir, a strong CYP3A4 inhibitor, and can raise imatinib plasma concentrations. Higher imatinib exposure may increase fluid retention, myelosuppression, hepatotoxicity and gastrointestinal effects.
How serious is the interaction between Imatinib 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: Prefer an antiretroviral regimen without a strong CYP3A4 inhibitor. If the combination is necessary, consider reducing the imatinib dose and monitor blood counts, liver enzymes and fluid status.
What other medicines interact with Imatinib?
MediHelp also lists interactions of Imatinib with, for example, Lomitapide, Lonafarnib, Amobarbital. The full list is on the Imatinib page.
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