Quality of Evidence:
Coadministration has not been studied and is not recommended. Erythromycin concentrations may increase due to inhibition of CYP3A4 by lopinavir/ritonavir. In addition, caution should be exercised as both drugs have risks of QT prolongation and/or TdP on the CredibleMeds.org website (possible risk for lopinavir; known risk for erythromycin). If coadministration is necessary, clinical monitoring including ECG assessment is recommended.
LHPG Comment: Note the difference in recommendations between the SPC (Europe) and Prescribing Information (US). The charts reflect the more cautious option.
Particular caution must be used when prescribing Kaletra and medicinal products known to induce QT interval prolongation such as erythromycin. Indeed, Kaletra could increase concentrations of the co-administered medicinal product and this may result in an increase of the associated cardiac adverse events. Cardiac events have been reported with Kaletra in preclinical studies; therefore, the potential cardiac effects of Kaletra cannot be currently ruled out. Kaletra Summary of Product Characteristics, AbbVie Ltd, January 2021.
Based on known metabolic profiles, a clinically significant interaction is not expected between lopinavir and erythromycin. Kaletra Prescribing Information, AbbVie Ltd, October 2020.
View all available interactions with
Lopinavir/ritonavir (LPV/r) by clicking