Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2007 Aug 14;177(4):357-9.
doi: 10.1503/cmaj.061284.

Interaction between lopinavir/ritonavir and warfarin

Christine A Hughes  1 , Andrea Freitas, Lilly J Miedzinski
Affiliations
Case Reports

Interaction between lopinavir/ritonavir and warfarin

Christine A Hughes et al. CMAJ. .

Abstract

Drug interactions involving protease inhibitors are common. Protease inhibitors are well known inhibitors of the 3A4 isozyme of cytochrome P450. Select protease inhibitors, including co-formulated lopinavir/ritonavir, may induce glucuronidation or the activity of other CYP450 isozymes. We describe the case of a patient taking warfarin who experienced a significantly decreased international normalized ratio after the initiation of antiretroviral therapy that included lopinavir/ritonavir. We review the possible mechanisms of this interaction and the reported interactions between warfarin and other protease inhibitors.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Department of Health and Human Services (DHHS) Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1 infected adults and adolescents. Bethesda (MD): National Institutes of Health; 2006. Available: http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf (accessed 2007 Apr 17).
    1. Cvetkovic RS, Goa KL. Lopinavir/ritonavir: a review of its use in the management of HIV infection. Drugs 2003;63:769-802. - PubMed
    1. Kaletra drug monograph. In: Repchinsky C, editor. Compendium of pharmaceuticals and specialties, online version (e-CPS). Ottawa: Canadian Pharmacists Association; 2006 (accessed 2006 July 11).
    1. Niopas I, Toon S. Aarons, Rowland M. The effect of cimetidine on the steady-state pharmacokinetics and pharmacodynamics of warfarin in humans. Eur J Clin Pharmacol 1999;55:399-404. - PubMed
    1. Warfarin drug monograph. In: Repchinsky C, editor. Compendium of pharmaceuticals and specialties, online version (e-CPS). Ottawa: Canadian Pharmacists Association; 2006 (accessed 2006 July 11).

Publication types