Drug interactions
Lopinavir + Trimipramine
Severity: Major
Lopinavir and Trimipramine: 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, boosted with ritonavir, inhibits CYP3A4 and CYP2D6, which can raise tricyclic concentrations. This may cause greater sedation, anticholinergic effects and cardiac conduction or QT effects. Lopinavir itself may also prolong QT.
What this interaction means in plain words
Lopinavir and Trimipramine 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; Trimipramine belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 and CYP2D6 metabolism of trimipramine by ritonavir-boosted lopinavir.
What to do
Start trimipramine at a low dose and titrate to response, using plasma level monitoring if available. Obtain an ECG and monitor for tricyclic toxicity.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine 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 Trimipramine?
MediHelp rates the interaction as major. Lopinavir and Trimipramine 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, boosted with ritonavir, inhibits CYP3A4 and CYP2D6, which can raise tricyclic concentrations. This may cause greater sedation, anticholinergic effects and cardiac conduction or QT effects. Lopinavir itself may also prolong QT.
How serious is the interaction between Lopinavir and Trimipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start trimipramine at a low dose and titrate to response, using plasma level monitoring if available. Obtain an ECG and monitor for tricyclic toxicity.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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