Drug Interactions
See also How to Use section. Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first. Lopinavir/ritonavir interacts with many medications. Other medications can affect the removal of lopinavir/ritonavir from your body, which may affect how lopinavir/ritonavir works. In addition, lopinavir/ritonavir can slow down or speed up the removal of other medications from your body, which may affect how they work. Before taking lopinavir/ritonavir, tell your doctor or pharmacist about all medications and products you may use. This drug should not be used with the following medications because very serious interactions may occur: alfuzosin, certain non-drowsy antihistamines, bosentan, cisapride, conivaptan, eletriptan, eplerenone, ergot drugs (e.g., dihydroergotamine, ergonovine, methylergonovine, ergotamine), ivabradine, pimozide, ranolazine, rifampin, certain sedatives (midazolam, triazolam), sildenafil (when used to treat pulmonary hypertension), certain "statins" (lovastatin, simvastatin), St John's wort, voriconazole. If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting lopinavir/ritonavir. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: other HIV drugs (e.g., efavirenz, amprenavir, zidovudine, abacavir, nevirapine, atazanavir, tipranavir/ritonavir), antidepressants (e.g., bupropion, trazodone), atovaquone, other azole antifungals (ketoconazole, itraconazole), "blood thinners" (e.g., warfarin), calcium channel blockers (e.g., felodipine, nifedipine, nicardipine), some cancer drugs (e.g., dasatinib, lapatinib, sunitinib, vinblastine, vincristine), dexamethasone, drugs for erectile dysfunction/drugs to treat pulmonary hypertension (e.g., sildenafil, tadalafil, vardenafil), certain inhaled drugs to treat breathing problems (e.g., fluticasone, salmeterol), garlic supplements, heart rhythm medication (e.g., amiodarone, bepridil, lidocaine, quinidine), drugs that suppress the immune system (e.g., cyclosporine, tacrolimus, rapamycin), macrolide antibiotics (e.g., clarithromycin), narcotic pain medications (e.g., methadone), rifabutin, other sedatives (alprazolam, zolpidem), seizure medication (e.g., phenytoin, carbamazepine, phenobarbital), solifenacin, certain other "statins" (atorvastatin, rosuvastatin), temsirolimus. Many drugs besides lopinavir/ritonavir may affect the heart rhythm (QT prolongation), including dofetilide, procainamide, sotalol, among others. This medication may decrease the effectiveness of combination-type birth control pills. This can result in pregnancy. You may need to use an additional form of reliable birth control while using this medication. Consult your doctor or pharmacist for details. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.