Drug interactions
Lopinavir + Primaquine
Severity: Major
Lopinavir and Primaquine: 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/ritonavir can prolong the QT interval and primaquine may add to this effect. The combination increases arrhythmia risk, particularly with electrolyte disturbance or cardiac disease.
What this interaction means in plain words
Lopinavir and Primaquine 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; Primaquine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation; ritonavir may also inhibit CYP3A4 and raise primaquine exposure.
What to do
Use an alternative if possible. If both are needed, obtain a baseline ECG, correct electrolytes and monitor the QTc.
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 Primaquine
- Pimozide + Primaquine Contraindicated
- Amiodarone + Primaquine Major
- Amisulpride + Primaquine Major
- Anagrelide + Primaquine Major
- Arsenic trioxide + Primaquine Major
- Asenapine + Primaquine 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 Primaquine?
MediHelp rates the interaction as major. Lopinavir and Primaquine 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 interval and primaquine may add to this effect. The combination increases arrhythmia risk, particularly with electrolyte disturbance or cardiac disease.
How serious is the interaction between Lopinavir and Primaquine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative if possible. If both are needed, obtain a baseline ECG, correct electrolytes and monitor the QTc.
What other medicines interact with Primaquine?
MediHelp also lists interactions of Primaquine with, for example, Pimozide, Amiodarone, Amisulpride. The full list is on the Primaquine page.
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