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Lopinavir and ritonavir and Xarelto Starter Pack

Determining the interaction of Lopinavir and ritonavir and Xarelto Starter Pack and the possibility of their joint administration.

Check result:
Lopinavir and ritonavir <> Xarelto Starter Pack
Relevance: 14.10.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Talk to your doctor before using rivaroxaban together with ritonavir. Combining these medications can significantly increase the blood levels of rivaroxaban and increase the risk of serious or life-threatening bleeding complications. If treatment with the combination is required, you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Call your doctor promptly if you experience any unusual bleeding or bruising, swelling, vomiting, blood in your urine or stools, headache, dizziness, or weakness during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 that can also inhibit P-glycoprotein (P-gp) may significantly increase the plasma concentrations of rivaroxaban, which is a substrate of both the isoenzyme and efflux transporter. The risk of bleeding associated with rivaroxaban may be increased. When rivaroxaban was coadministered with the dual P-gp and potent CYP450 3A4 inhibitor, ketoconazole (400 mg once daily), mean steady-state rivaroxaban peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 1.7- and 2.6-fold, respectively. Likewise, coadministration with ritonavir 600 mg twice a day increased the mean steady-state rivaroxaban Cmax by 1.6-fold and AUC by 2.5-fold. Significant increases in pharmacodynamic effects of rivaroxaban were observed with both drugs.

MANAGEMENT: Concomitant use of rivaroxaban with dual P-gp and potent CYP450 3A4 inhibitors should generally be avoided.

References
  • "Product Information. Xarelto (rivaroxaban)." Bayer Inc, Toronto, IA.
  • "Product Information. Evotaz (atazanavir-cobicistat)." Bristol-Myers Squibb, Princeton, NJ.
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Lopinavir and ritonavir

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: Lopinavir and Ritonavir

Xarelto Starter Pack

Generic Name: rivaroxaban

Brand name: Xarelto, Xarelto Starter Pack

Synonyms: Xarelto

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle