Drug interactions
Lopinavir + Memantine-donepezil
Severity: Major
Lopinavir and Memantine-donepezil: 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/ritonavir can prolong the QT and PR intervals and donepezil can also prolong QT. Ritonavir inhibits CYP3A4, which may raise donepezil concentrations and further increase cardiac risk.
What this interaction means in plain words
Lopinavir and Memantine-donepezil 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 belongs to Anti Virals; Memantine-donepezil belongs to Central Nervous System.
Why it happens
Additive QT prolongation plus CYP3A4 inhibition by ritonavir raising donepezil exposure.
What to do
Obtain a baseline ECG and monitor QTc and heart rate, and correct electrolytes. Watch for cholinergic effects such as bradycardia and consider donepezil dose reduction.
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 Memantine-donepezil
- Dronedarone + Memantine-donepezil Contraindicated
- Memantine-donepezil + Thioridazine Contraindicated
- Amantadine + Memantine-donepezil Major
- Amiodarone + Memantine-donepezil Major
- Amisulpride + Memantine-donepezil Major
- Amitriptyline + Memantine-donepezil 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 Lopinavir with Memantine-donepezil?
MediHelp rates the interaction as major. Lopinavir and Memantine-donepezil 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 can prolong the QT and PR intervals and donepezil can also prolong QT. Ritonavir inhibits CYP3A4, which may raise donepezil concentrations and further increase cardiac risk.
How serious is the interaction between Lopinavir and Memantine-donepezil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor QTc and heart rate, and correct electrolytes. Watch for cholinergic effects such as bradycardia and consider donepezil dose reduction.
What other medicines interact with Memantine-donepezil?
MediHelp also lists interactions of Memantine-donepezil with, for example, Dronedarone, Thioridazine, Amantadine. The full list is on the Memantine-donepezil page.
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