Interaction Checker
Do Not Coadminister
Lopinavir/ritonavir (LPV/r)
Amiodarone
Quality of Evidence: Moderate
Summary:
Coadministration has not been studied. Amiodarone is metabolised by CYP3A4 and concentrations may be increased due to inhibition of CYP3A4 by lopinavir/ritonavir. Coadministration is contraindicated in European SPC but the US Prescribing Information suggests caution and concentration monitoring (if available). Furthermore, both drugs have a risk of QT prolongation and/or TdP on the CredibleMeds.org website (possible risk for lopinavir; known risk for amiodarone). Caution should be exercised if coadministered. ECG monitoring is recommended.
Description:
LHPG Comment: Note the difference in recommendations between the SPC (Europe) and Prescribing Information (US). The charts reflect the more cautious option.
Concomitant administration of Kaletra and amiodarone is contraindicated as the risk of arrhythmias or other serious adverse reactions may be increased. Amiodarone concentrations may be increased due to CYP3A4 inhibition by lopinavir/ritonavir. Kaletra contains lopinavir and ritonavir, both of which are inhibitors of the P450 isoform CYP3A. Kaletra should not be co-administered with medicinal products that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life threatening events. These medicinal products include amiodarone.
Kaletra Summary of Product Characteristics, AbbVie Ltd, January 2021.
Coadministration of Kaletra with the antiarrhythmic amiodarone may result in increased concentrations of amiodarone. Caution is warranted and therapeutic concentration monitoring is recommended for antiarrhythmics when coadministered with Kaletra, if available.
Kaletra Prescribing Information, AbbVie Ltd, October 2020.
View all available interactions with Lopinavir/ritonavir (LPV/r) by clicking here.
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