Drug interactions
Lopinavir + Vinorelbine
Severity: Major
Lopinavir and Vinorelbine: major interaction.
Last updated Sources: UK SmPC
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 may substantially increase vinorelbine exposure. This raises the risk of severe neutropenia and neurotoxicity.
What this interaction means in plain words
Lopinavir and Vinorelbine 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; Vinorelbine belongs to Oncology.
Why it happens
Ritonavir-boosted lopinavir inhibits CYP3A4 metabolism of vinorelbine.
What to do
Monitor blood counts frequently and reduce the vinorelbine dose, or choose an antiretroviral regimen without CYP3A inhibition.
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
- Navelbine 20mg soft capsule - SmPC sections 4.3/4.5 (class statement: strong inhibitors of this isoenzyme; "combination with strong inhibitors of this isoenzyme (e.g., azole antifungals such as ketoconazole and itraconazole) could increase blood concentrations of vino") — electronic medicines compendium (UK SmPC)
Other interactions of Vinorelbine
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 Vinorelbine?
MediHelp rates the interaction as major. Lopinavir and Vinorelbine 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 may substantially increase vinorelbine exposure. This raises the risk of severe neutropenia and neurotoxicity.
How serious is the interaction between Lopinavir and Vinorelbine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts frequently and reduce the vinorelbine dose, or choose an antiretroviral regimen without CYP3A inhibition.
What other medicines interact with Vinorelbine?
MediHelp also lists interactions of Vinorelbine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Belatacept. The full list is on the Vinorelbine page.
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