Drug interactions
Lopinavir + Warfarin
Severity: Moderate
Lopinavir and Warfarin: moderate 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, given with ritonavir, may change warfarin clearance through mixed enzyme effects. INR may fall or rise, creating risk of clotting or bleeding.
What this interaction means in plain words
Lopinavir and Warfarin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Lopinavir belongs to Anti Virals; Warfarin belongs to Cardiovascular.
Why it happens
Mixed inhibition and induction of CYP enzymes, including CYP2C9, by the ritonavir-boosted regimen.
What to do
Monitor INR closely after starting or stopping lopinavir/ritonavir. Adjust warfarin dosing as needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
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 Warfarin?
MediHelp rates the interaction as moderate. Lopinavir and Warfarin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lopinavir, given with ritonavir, may change warfarin clearance through mixed enzyme effects. INR may fall or rise, creating risk of clotting or bleeding.
How serious is the interaction between Lopinavir and Warfarin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor INR closely after starting or stopping lopinavir/ritonavir. Adjust warfarin dosing as needed.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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