Drug interactions
Itraconazole + Lopinavir
Severity: Major
Itraconazole and Lopinavir: major interaction.
Last updated Sources: US FDA label
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/ritonavir inhibits CYP3A4 and can raise itraconazole concentrations, and itraconazole may also raise lopinavir levels. Both can prolong the QT interval, and ritonavir boosting heightens the risk of adverse effects.
What this interaction means in plain words
Itraconazole 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.
Itraconazole belongs to Anti Fungals; Lopinavir belongs to Anti Virals.
Why it happens
Mutual CYP3A4 inhibition with additive QT prolongation.
What to do
Limit the itraconazole dose (high doses are not recommended) and monitor itraconazole levels, ECG and for toxicity. Consider an alternative antifungal.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole 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 Itraconazole with Lopinavir?
MediHelp rates the interaction as major. Itraconazole 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/ritonavir inhibits CYP3A4 and can raise itraconazole concentrations, and itraconazole may also raise lopinavir levels. Both can prolong the QT interval, and ritonavir boosting heightens the risk of adverse effects.
How serious is the interaction between Itraconazole 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: Limit the itraconazole dose (high doses are not recommended) and monitor itraconazole levels, ECG and for toxicity. Consider an alternative antifungal.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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