Drug interactions
Lopinavir + Ruxolitinib
Severity: Major
Lopinavir and Ruxolitinib: major interaction.
Last updated Sources: UK SmPC
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, co-formulated with ritonavir, inhibits CYP3A4 and raises ruxolitinib exposure. The increase may be modest but can still worsen cytopenias and infection risk.
What this interaction means in plain words
Lopinavir and Ruxolitinib 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; Ruxolitinib belongs to Oncology.
Why it happens
CYP3A4 inhibition by ritonavir-boosted lopinavir reduces ruxolitinib clearance.
What to do
Reduce the ruxolitinib dose per labeling for strong CYP3A4 inhibitors. Monitor blood counts frequently.
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 Ruxolitinib
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 Ruxolitinib?
MediHelp rates the interaction as major. Lopinavir and Ruxolitinib 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, co-formulated with ritonavir, inhibits CYP3A4 and raises ruxolitinib exposure. The increase may be modest but can still worsen cytopenias and infection risk.
How serious is the interaction between Lopinavir and Ruxolitinib?
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 ruxolitinib dose per labeling for strong CYP3A4 inhibitors. Monitor blood counts frequently.
What other medicines interact with Ruxolitinib?
MediHelp also lists interactions of Ruxolitinib with, for example, Atazanavir, Ceritinib, Chloramphenicol. The full list is on the Ruxolitinib page.
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