Drug interactions
Lopinavir + Tinidazole
Severity: Major
Lopinavir and Tinidazole: major interaction.
Last updated
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 oral solution contains a large amount of ethanol, and tinidazole can cause a disulfiram-like reaction with alcohol, producing flushing, nausea, vomiting and palpitations. Lopinavir may also raise tinidazole exposure through CYP3A4 inhibition, although the alcohol content is the main concern.
What this interaction means in plain words
Lopinavir and Tinidazole 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; Tinidazole belongs to Anti Parasitic.
Why it happens
Ethanol in the oral solution combined with tinidazole's disulfiram-like effect, plus possible CYP3A4 inhibition by the ritonavir component of the co-formulation.
What to do
Avoid the lopinavir/ritonavir oral solution during tinidazole therapy and for 3 days after the last dose; use the tablet formulation if the combination is necessary.
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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Other interactions of Tinidazole
- Disulfiram + Tinidazole Contraindicated
- Ethanol + Tinidazole Major
- Fexinidazole + Tinidazole Major
- Nilotinib + Tinidazole Major
- Ritonavir + Tinidazole Major
- Amiodarone + Tinidazole Moderate
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 Tinidazole?
MediHelp rates the interaction as major. Lopinavir and Tinidazole 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 oral solution contains a large amount of ethanol, and tinidazole can cause a disulfiram-like reaction with alcohol, producing flushing, nausea, vomiting and palpitations. Lopinavir may also raise tinidazole exposure through CYP3A4 inhibition, although the alcohol content is the main concern.
How serious is the interaction between Lopinavir and Tinidazole?
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 lopinavir/ritonavir oral solution during tinidazole therapy and for 3 days after the last dose; use the tablet formulation if the combination is necessary.
What other medicines interact with Tinidazole?
MediHelp also lists interactions of Tinidazole with, for example, Disulfiram, Ethanol, Fexinidazole. The full list is on the Tinidazole page.
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