Drug interactions
Lopinavir + Ribociclib
Severity: Major
Lopinavir and Ribociclib: 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 strongly inhibits CYP3A4 and raises ribociclib exposure, and both drugs prolong the QT interval. This combination increases the risk of arrhythmia and myelosuppression.
What this interaction means in plain words
Lopinavir and Ribociclib 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; Ribociclib belongs to Oncology.
Why it happens
CYP3A4 inhibition increasing ribociclib levels plus additive QTc prolongation.
What to do
Avoid if possible and select a different antiretroviral. If unavoidable, reduce ribociclib to 400 mg daily and monitor ECG, electrolytes and blood counts.
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 Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib 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 Ribociclib?
MediHelp rates the interaction as major. Lopinavir and Ribociclib 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 strongly inhibits CYP3A4 and raises ribociclib exposure, and both drugs prolong the QT interval. This combination increases the risk of arrhythmia and myelosuppression.
How serious is the interaction between Lopinavir and Ribociclib?
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 if possible and select a different antiretroviral. If unavoidable, reduce ribociclib to 400 mg daily and monitor ECG, electrolytes and blood counts.
What other medicines interact with Ribociclib?
MediHelp also lists interactions of Ribociclib with, for example, Amiodarone, Cisapride, Dofetilide. The full list is on the Ribociclib page.
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