Drug interactions
Lopinavir + Paclitaxel
Severity: Major
Lopinavir and Paclitaxel: 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, given with ritonavir, strongly inhibits CYP3A4, which contributes to paclitaxel clearance. Paclitaxel exposure may rise, increasing the risk of neutropenia, neuropathy and other toxicities.
What this interaction means in plain words
Lopinavir and Paclitaxel 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; Paclitaxel belongs to Oncology.
Why it happens
Inhibition of CYP3A4 (and possibly P-gp) by the ritonavir-boosted lopinavir reduces paclitaxel metabolism.
What to do
Prefer an antiretroviral regimen without a boosted protease inhibitor during paclitaxel therapy. If the combination is unavoidable, monitor blood counts and neuropathy closely and consider paclitaxel 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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References
Other interactions of Paclitaxel
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 Paclitaxel?
MediHelp rates the interaction as major. Lopinavir and Paclitaxel 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, given with ritonavir, strongly inhibits CYP3A4, which contributes to paclitaxel clearance. Paclitaxel exposure may rise, increasing the risk of neutropenia, neuropathy and other toxicities.
How serious is the interaction between Lopinavir and Paclitaxel?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an antiretroviral regimen without a boosted protease inhibitor during paclitaxel therapy. If the combination is unavoidable, monitor blood counts and neuropathy closely and consider paclitaxel dose reduction.
What other medicines interact with Paclitaxel?
MediHelp also lists interactions of Paclitaxel with, for example, Adenovirus types 4 and 7 live, Cobicistat, Cyclosporine. The full list is on the Paclitaxel page.
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