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Drug interactions

Lopinavir + Nilotinib

Severity: Major

Lopinavir and Nilotinib: 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, boosted with ritonavir, strongly inhibits CYP3A4 and can substantially raise nilotinib concentrations. Both drugs can prolong the QT interval, so the arrhythmia risk is increased.

What this interaction means in plain words

Lopinavir and Nilotinib 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; Nilotinib belongs to Oncology.

Evidence level: Moderate

Why it happens

CYP3A4 inhibition by lopinavir/ritonavir reduces nilotinib clearance, with additive QT effects.

What to do

Avoid the combination if possible. If necessary, reduce the nilotinib dose per labeling for strong CYP3A4 inhibitors and monitor ECG 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Lopinavir with Nilotinib?

MediHelp rates the interaction as major. Lopinavir and Nilotinib 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, boosted with ritonavir, strongly inhibits CYP3A4 and can substantially raise nilotinib concentrations. Both drugs can prolong the QT interval, so the arrhythmia risk is increased.

How serious is the interaction between Lopinavir and Nilotinib?

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 if possible. If necessary, reduce the nilotinib dose per labeling for strong CYP3A4 inhibitors and monitor ECG and electrolytes.

What other medicines interact with Nilotinib?

MediHelp also lists interactions of Nilotinib with, for example, Amiodarone, Arsenic trioxide, Disopyramide. The full list is on the Nilotinib page.

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