Drug interactions
Lopinavir + Tolvaptan
Severity: Contraindicated
Lopinavir and Tolvaptan: contraindicated 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 co-formulated with ritonavir and strongly inhibits CYP3A4, so tolvaptan exposure is expected to rise considerably. This risks excessive aquaresis, dehydration, and overly rapid sodium correction.
What this interaction means in plain words
Lopinavir and Tolvaptan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Lopinavir belongs to Anti Virals; Tolvaptan belongs to Endocrine.
Why it happens
Ritonavir-boosted CYP3A4 inhibition reduces tolvaptan metabolism.
What to do
Do not co-administer; choose an alternative therapy or interrupt tolvaptan, and monitor serum sodium.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan 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 Tolvaptan?
MediHelp rates the interaction as contraindicated. Lopinavir and Tolvaptan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Lopinavir is co-formulated with ritonavir and strongly inhibits CYP3A4, so tolvaptan exposure is expected to rise considerably. This risks excessive aquaresis, dehydration, and overly rapid sodium correction.
How serious is the interaction between Lopinavir and Tolvaptan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; choose an alternative therapy or interrupt tolvaptan, and monitor serum sodium.
What other medicines interact with Tolvaptan?
MediHelp also lists interactions of Tolvaptan with, for example, Atazanavir, Ceritinib, Cobicistat. The full list is on the Tolvaptan page.
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