Drug interactions
Lopinavir + Salmeterol
Severity: Major
Lopinavir and Salmeterol: 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 substantially increases salmeterol exposure. This may cause QT prolongation, tachycardia and hypokalemia.
What this interaction means in plain words
Lopinavir and Salmeterol 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; Salmeterol belongs to Respiratory.
Why it happens
CYP3A4 inhibition reduces salmeterol metabolism.
What to do
Avoid concurrent use and choose formoterol. If unavoidable, monitor ECG and potassium.
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 Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Atazanavir + Salmeterol Major
- Budesonide-formoterol + Salmeterol 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 Salmeterol?
MediHelp rates the interaction as major. Lopinavir and Salmeterol 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 substantially increases salmeterol exposure. This may cause QT prolongation, tachycardia and hypokalemia.
How serious is the interaction between Lopinavir and Salmeterol?
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 concurrent use and choose formoterol. If unavoidable, monitor ECG and potassium.
What other medicines interact with Salmeterol?
MediHelp also lists interactions of Salmeterol with, for example, Ritonavir, Saquinavir, Amitriptyline. The full list is on the Salmeterol page.
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