Interaction Checker
Potential Interaction
Lopinavir/ritonavir (LPV/r)
Nilotinib
Quality of Evidence: Very Low
Summary:
Coadministration has not been studied. Nilotinib is metabolized by CYP3A4 and coadministration of lopinavir/ritonavir could potentially increase nilotinib concentrations. Ketoconazole (a strong CYP3A4 inhibitor) increased nilotinib AUC by 3-fold. A similar effect is expected with lopinavir/ritonavir. Caution should be exercised as both drugs have possible risks of QT prolongation and/or TdP on the CredibleMeds.org website. Avoid combination if possible or monitor both drugs closely, including ECG assessment. Lopinavir/ritonavir and nilotinib should not be coadministered in patients with accelerated or blast phase chronic myelogenous leukaemia (CML). For this particular indication, maintain nilotinib treatment and consider an alternative antiretroviral regimen. In chronic phase CML, if coadministration with a strong CYP3A4 inhibitor is unavoidable, the nilotinib dose may be reduced from 400 mg twice daily to once daily.
Description:
Particular caution must be used when prescribing Kaletra and medicinal products known to induce QT interval prolongation. Indeed, Kaletra could increase concentrations of the co-administered medicinal products and this may result in an increase of their 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. There is risk of increased adverse events due to higher serum concentrations because of CYP3A4 inhibition by lopinavir/ritonavir requiring careful monitoring of the tolerance of this anticancer agent.
Kaletra Summary of Product Characteristics, AbbVie Ltd, January 2021.
Coadministration is expected to increase nilotinib concentrations. A decrease in the dosage or an adjustment of the dosing interval of nilotinib may be necessary for patients requiring co-administration with strong CYP3A inhibitors such as Kaletra. Please refer to the nilotinib prescribing information for dosing instructions.
Kaletra Prescribing Information, AbbVie Inc, October 2020.
View all available interactions with Lopinavir/ritonavir (LPV/r) by clicking here.
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