Drug interactions
Ketoconazole + Lopinavir
Severity: Moderate
Ketoconazole 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
Ketoconazole raises lopinavir concentrations, and the ritonavir in lopinavir/ritonavir in turn raises ketoconazole levels. This increases the risk of adverse effects from both drugs, including hepatotoxicity and QT prolongation.
What this interaction means in plain words
Ketoconazole 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.
Ketoconazole belongs to Anti Fungals; Lopinavir belongs to Anti Virals.
Why it happens
Mutual CYP3A4 inhibition reduces clearance of both drugs.
What to do
Do not exceed ketoconazole 200 mg/day with lopinavir/ritonavir and monitor liver function and for adverse effects.
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 Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole 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 Ketoconazole with Lopinavir?
MediHelp rates the interaction as moderate. Ketoconazole 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. Ketoconazole raises lopinavir concentrations, and the ritonavir in lopinavir/ritonavir in turn raises ketoconazole levels. This increases the risk of adverse effects from both drugs, including hepatotoxicity and QT prolongation.
How serious is the interaction between Ketoconazole 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: Do not exceed ketoconazole 200 mg/day with lopinavir/ritonavir and monitor liver function and for adverse effects.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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