Drug interactions
Lopinavir + Oxycodone
Severity: Major
Lopinavir and Oxycodone: 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 is co-formulated with ritonavir, a strong CYP3A4 inhibitor, which can substantially increase oxycodone exposure. This raises the risk of profound sedation and respiratory depression.
What this interaction means in plain words
Lopinavir and Oxycodone 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; Oxycodone belongs to Musculoskeletal.
Why it happens
Ritonavir-boosted lopinavir inhibits CYP3A4 metabolism of oxycodone, increasing its plasma concentration.
What to do
Start with a reduced oxycodone dose and titrate cautiously, monitoring for respiratory depression and sedation. Consider a non-CYP3A4 opioid if feasible.
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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate 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 Lopinavir with Oxycodone?
MediHelp rates the interaction as major. Lopinavir and Oxycodone 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, which can substantially increase oxycodone exposure. This raises the risk of profound sedation and respiratory depression.
How serious is the interaction between Lopinavir and Oxycodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with a reduced oxycodone dose and titrate cautiously, monitoring for respiratory depression and sedation. Consider a non-CYP3A4 opioid if feasible.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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