Drug interactions
Lopinavir + Quetiapine
Severity: Major
Lopinavir and Quetiapine: 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
Ritonavir-boosted lopinavir inhibits CYP3A4 and raises quetiapine exposure, increasing the risk of oversedation, hypotension and QT prolongation. Lopinavir/ritonavir may also itself prolong QT.
What this interaction means in plain words
Lopinavir and Quetiapine 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; Quetiapine belongs to Central Nervous System.
Why it happens
CYP3A4 inhibition (mainly by ritonavir) reduces quetiapine clearance.
What to do
Reduce the quetiapine dose substantially when starting the combination and titrate to response. Monitor sedation, blood pressure and ECG, and restore the dose when the inhibitor is stopped.
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 Quetiapine
- Adagrasib + Quetiapine Major
- Amiodarone + Quetiapine Major
- Amisulpride + Quetiapine Major
- Amoxapine + Quetiapine Major
- Anagrelide + Quetiapine Major
- Apalutamide + Quetiapine 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 Quetiapine?
MediHelp rates the interaction as major. Lopinavir and Quetiapine 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. Ritonavir-boosted lopinavir inhibits CYP3A4 and raises quetiapine exposure, increasing the risk of oversedation, hypotension and QT prolongation. Lopinavir/ritonavir may also itself prolong QT.
How serious is the interaction between Lopinavir and Quetiapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the quetiapine dose substantially when starting the combination and titrate to response. Monitor sedation, blood pressure and ECG, and restore the dose when the inhibitor is stopped.
What other medicines interact with Quetiapine?
MediHelp also lists interactions of Quetiapine with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Quetiapine page.
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