Lopinavir concentrations may be decreased due to CYP3A induction by dexamethasone. Clinical monitoring of antiviral efficacy is recommended when concomitantly administered with Kaletra.

Coadministration is expected to decrease lopinavir concentrations and increase concentrations of dexamethasone. Coadministration with oral dexamethasone or other systemic corticosteroids that induce CYP3A may result in loss of therapeutic effect and development of resistance to lopinavir. Consider alternative corticosteroids. Coadministration with corticosteroids whose exposures are significantly increased by strong CYP3A inhibitors can increase the risk for Cushing’s syndrome and adrenal suppression. Alternative corticosteroids including beclomethasone and prednisolone (whose PK and/or PD are less affected by strong CYP3A inhibitors relative to other studied steroids) should be considered, particularly for long-term use.