Drug combination No. R1 Mechanism/Effect Recommendations
Lopinavir/Ritonavir + Atorvastatin 32 F CYP3A4 inhibitors2 may increase the serum concentration of atorvastatin Start with the lowest possible atorvastatin dose, monitor for signs and symptoms of toxicity
Aspirin + Enoxaparin 13 F Antiplatelet agents may enhance the anticoagulant effect of Enoxaparin Monitor closely for signs and symptoms of bleeding
Lopinavir/Ritonavir + Alprazolam 10 G CYP3A4 inhibitors may increase the serum concentration of alprazolam Consider using an alternative
Clopidogrel + Enoxaparin 5 F Antiplatelet agents may enhance the anticoagulant effect of enoxaparin Monitor closely for signs and symptoms of bleeding
Lopinavir/Ritonavir + Dexamethasone 5 F CYP3A4 inhibitors may increase the serum concentration of dexamethasone Monitor for increased adverse effects of dexamethasone, consider dose reduction
Lopinavir/Ritonavir + Prednisolone 5 F CYP3A4 Inhibitors may increase the serum concentration of prednisolone Monitor for increased adverse effects of prednisolone, consider dose reduction
Lopinavir/Ritonavir + Rosuvastatin 5 F CYP3A4 Inhibitors may increase the serum concentration of rosuvastatin Start with the lowest possible rosuvastatin dose, monitor for signs and symptoms of toxicity
Naproxen + Enoxaparin 4 F NSAIDs3 may enhance the anticoagulant effect of enoxaparin Monitor closely for signs and symptoms of bleeding
Naproxen + Heparin 4 F NSAIDs may enhance the anticoagulant effect of heparin Decrease the dose of heparin or NSAIDs
Ibuprofen + Enoxaparin 3 F NSAIDs may enhance the anticoagulant effect of enoxaparin Monitor closely for signs and symptoms of bleeding
Indomethacin + Heparin 3 F NSAIDs may enhance the anticoagulant effect of heparin Decrease the dose of heparin or NSAIDs
Lopinavir/Ritonavir + Fentanyl 3 F CYP3A4 inhibitors may increase the serum concentration of fentanyl Monitor for increased adverse effects of fentanyl, consider dose reduction
Lopinavir/Ritonavir + Quetiapine 3 F CYP3A4 inhibitors may increase the serum concentration of quetiapine Consider using an alternative or reduce the quetiapine dose to one-sixth of the original dose
Carbamazepine + Lopinavir/Ritonavir
2
F
Carbamazepine may decrease the serum concentration of lopinavir
Use a twice daily lopinavir/ritonavir regimen, monitor for reduced effect of lopinavir/ritonavir
Clopidogrel + Heparin 2 F Antiplatelet agents may enhance the anticoagulant effect of heparin Decrease the dose of heparin or clopidogrel
Indomethacin + Enoxaparin 2 F NSAIDs may enhance the anticoagulant effect of enoxaparin Monitor closely for signs and symptoms of bleeding
Midazolam + Fentanyl 2 F Increased CNS depressant effects Close monitoring for adverse effects
Propofol + Fentanyl 2 F Increase CNS depressant effects Close monitoring for adverse effects
Lopinavir/Ritonavir + Chlordiazepoxide 2 F CYP3A4 inhibitors may increase the serum concentration of chlordiazpoxide Monitor for increased adverse effects of chlordiazpoxide
Lopinavir/Ritonavir + Digoxin 2 G Ritonavir may increase the serum concentration of digoxin Reduce the digoxin dose (30% to 50%) or the dosing frequency, Monitor digoxin levels
Lopinavir/Ritonavir + Oxycodone 2 F CYP3A4 inhibitors may increase the serum concentration of oxycodone Monitor for increased adverse effects of oxycodone