Co-administration is contraindicated. 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 ombitasvir/paritaprevir/ritonavir with or without dasabuvir due to increased plasma concentrations of paritaprevir; thereby, increasing the risk of alanine transaminase (ALT) elevations. Coadministration of ombitasvir/paritaprevir/ritonavir + dasabuvir (25/150/100 mg once daily + 400 mg twice daily) and lopinavir/ritonavir (400/100 mg twice daily) did not affect the pharmacokinetics of ombitasvir, dasabuvir or lopinavir. Paritaprevir AUC, Cmax and Ctrough increased by 2.17-, 2.04- and 2.36-fold, respectively. Coadministration of ombitasvir/paritaprevir/ritonavir (25/150/100 mg once daily) and lopinavir/ritonavir (400/100 mg twice daily) did not affect the pharmacokinetics of ombitasvir or lopinavir. Paritaprevir AUC, Cmax and Ctrough increased by 6.10-, 4.76- and 12.33-fold, respectively. Lopinavir/ritonavir 800/200 mg once daily was administered with ombitasvir/paritaprevir/ritonavir with or without dasabuvir. The effect on DAAs and lopinavir was similar to that observed when lopinavir/ritonavir 400/100 mg twice daily was administered.

Coadministration is expected to increase concentrations of ombitasvir, paritaprevir and ritonavir, but to have no effect on dasabuvir. It is not recommended to co-administer Kaletra and ombitasvir/paritaprevir/ritonavir and dasabuvir. Coadministration of ombitasvir/paritaprevir/ritonavir + dasabuvir (25/150/100 mg once daily + 400 mg twice daily) and lopinavir/ritonavir (400/100 mg twice daily) was studied in 6 subjects. Lopinavir Cmax and AUC decreased by 13% and 6%; Cmin increased by 15%. Ombitasvir Cmax, AUC and Cmin increased by 14%, 17% and 24%, respectively. Paritaprevir Cmax, AUC and Cmin increased by 104%, 117% and 136%, respectively. Ritonavir Cmax, AUC and Cmin increased by 55%, 105% and 425%, respectively. Dasabuvir Cmax, AUC and Cmin decreased by 1%, 7% and 32%, respectively.