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More Medications That Interact With Lopinavir and Ritonavir

Metronidazole
Lopinavir and ritonavir oral solution (but not tablets) contains alcohol, which may cause problems when combined with metronidazole.
 
Nevirapine
Nevirapine can lower the level of lopinavir and ritonavir in your blood, perhaps making it less effective. Your healthcare provider may need to increase your lopinavir and ritonavir dosage. When used in combination with nevirapine, once-daily dosing with lopinavir and ritonavir is not recommended (it should be taken twice a day instead).
 
Other Protease Inhibitors
Taking lopinavir and ritonavir with another protease inhibitor may increase or decrease the level of both medications in your blood. Check with your healthcare provider before taking lopinavir and ritonavir with another protease inhibitor.
 
In addition, combining atazanavir with lopinavir and ritonavir may increase the risk of a certain irregular heart rhythm known as heart block. This may be quite dangerous. If you take these medications together, your healthcare provider may want to monitor your heart to check for this problem.
 
Phosphodiesterase Type 5 Inhibitors (PDE5 Inhibitors)
Lopinavir and ritonavir can increase the level of PDE5 inhibitors in your blood, increasing your risk of side effects. Your healthcare provider may recommend a lower-than-typical dosage for your PDE5 inhibitor while you are taking lopinavir and ritonavir.
 
PDE5 inhibitors are used to treat erectile dysfunction or pulmonary arterial hypertension. Specific dosing recommendations are available for combining lopinavir and ritonavir with a PDE5 inhibitor if the PDE5 inhibitor is used to treat erectile dysfunction. Also, specific dosing recommendations are available for combining lopinavir and ritonavir with tadalafil when tadalafil is used to treat pulmonary arterial hypertension.
 
However, at this time it is not recommended to combine lopinavir and ritonavir with sildenafil when sildenafil is used to treat pulmonary arterial hypertension, as a safe and effective dosing regimen has not yet been determined for this situation.
 
Pimozide
Pimozide and lopinavir and ritonavir should not be taken together, due to the risk of dangerous reactions.
 
Rifampin
Lopinavir and ritonavir should never be combined with rifampin. Doing so may make it (and other similar HIV medications) permanently less effective.
 
Salmeterol
Combining salmeterol with lopinavir and ritonavir may increase the risk of serious side effects of salmeterol (especially heart problems). Check with your healthcare provider before combining such medications.
  
Seizure Medications
Some seizure medications can decrease the level of lopinavir and ritonavir in your blood, perhaps making it less effective. Check with your healthcare provider before taking lopinavir and ritonavir with a seizure medication. Additionally, lopinavir and ritonavir may decrease the level of phenytoin in your blood.
 
If you take lopinavir and ritonavir with phenytoin, your healthcare provider should monitor the level of phenytoin in your blood and adjust your phenytoin dosage as necessary.
 
Lopinavir and ritonavir may decrease the levels of lamotrigine or valproate (divalproex, valproic acid) in your blood, making it less effective. Your healthcare provider may need to increase the dose of your anticonvulsant medication, and blood levels of lamotrigine or valproate may need to be monitored while taking lopinavir and ritonavir.

Lopinavir and Ritonavir for HIV/AIDS

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