Drug interactions
Lopinavir + Quinidine
Severity: Major
Lopinavir and Quinidine: 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 given with ritonavir, a potent CYP3A4 inhibitor, and can substantially increase quinidine concentrations. Lopinavir/ritonavir also has QT prolonging potential, so the risk of torsades de pointes is increased.
What this interaction means in plain words
Lopinavir and Quinidine 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; Quinidine belongs to Anti Parasitic.
Why it happens
CYP3A4 inhibition by ritonavir-boosted lopinavir reduces quinidine metabolism, with additive QT effects.
What to do
Avoid the combination if possible. If used, monitor ECG and quinidine levels and reduce the quinidine dose accordingly.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine 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 Quinidine?
MediHelp rates the interaction as major. Lopinavir and Quinidine 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 given with ritonavir, a potent CYP3A4 inhibitor, and can substantially increase quinidine concentrations. Lopinavir/ritonavir also has QT prolonging potential, so the risk of torsades de pointes is increased.
How serious is the interaction between Lopinavir and Quinidine?
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 used, monitor ECG and quinidine levels and reduce the quinidine dose accordingly.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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