Drug interactions
Lopinavir + Vinblastine
Severity: Major
Lopinavir and Vinblastine: 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
Lopinavir is boosted with ritonavir, a strong CYP3A4 inhibitor, and can increase vinblastine exposure. Severe vinca alkaloid toxicity including profound neutropenia and neurotoxicity has been reported with strong CYP3A inhibitors.
What this interaction means in plain words
Lopinavir and Vinblastine 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; Vinblastine belongs to Oncology.
Why it happens
Ritonavir-boosted lopinavir inhibits CYP3A4 and P-gp, reducing vinblastine clearance.
What to do
Avoid the combination and use a non-boosted antiretroviral regimen if possible. If unavoidable, reduce the vinblastine dose and monitor blood counts and neurotoxicity.
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 Vinblastine
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 Vinblastine?
MediHelp rates the interaction as major. Lopinavir and Vinblastine 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 is boosted with ritonavir, a strong CYP3A4 inhibitor, and can increase vinblastine exposure. Severe vinca alkaloid toxicity including profound neutropenia and neurotoxicity has been reported with strong CYP3A inhibitors.
How serious is the interaction between Lopinavir and Vinblastine?
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 combination and use a non-boosted antiretroviral regimen if possible. If unavoidable, reduce the vinblastine dose and monitor blood counts and neurotoxicity.
What other medicines interact with Vinblastine?
MediHelp also lists interactions of Vinblastine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Atazanavir. The full list is on the Vinblastine page.
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