Drug interactions
Lopinavir + Voriconazole
Severity: Major
Lopinavir and Voriconazole: 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 co-formulated with ritonavir, which can lower voriconazole concentrations through enzyme induction, risking antifungal failure. Voriconazole may in turn alter lopinavir exposure.
What this interaction means in plain words
Lopinavir and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Ritonavir in the lopinavir/ritonavir combination induces voriconazole metabolism while both drugs interact at CYP3A4.
What to do
Avoid unless benefit outweighs risk. If used, monitor voriconazole trough levels and antiretroviral response and consider an alternative antifungal.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole 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 Voriconazole?
MediHelp rates the interaction as major. Lopinavir and Voriconazole 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 co-formulated with ritonavir, which can lower voriconazole concentrations through enzyme induction, risking antifungal failure. Voriconazole may in turn alter lopinavir exposure.
How serious is the interaction between Lopinavir and Voriconazole?
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 unless benefit outweighs risk. If used, monitor voriconazole trough levels and antiretroviral response and consider an alternative antifungal.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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