The U.S. Food and Drug Administration (FDA) has approved revisions to the label of the antiretroviral (ARV) Kaletra (lopinavir/ritonavir) in order to include new information on drug interactions. These include:
- Anticoagulants: Xarelto (rivaroxaban). Kaletra raises Xarelto levels and can raise the risk of increased bleeding. Avoid combining the two drugs.
- Anticonvulsants: Lamictal (lamotrigine) and valproate. Kaletra can lower their levels, potentially requiring a higher dose.
- Corticosteroids (systemic): Uceris (Budesonide) and prednisone. Combining Kaletra with either drug can increase steroid concentrations and reduce cortisol concentrations in the blood.
- Hepatitis C protease inhibitors: Victrelis (boceprevir) and Incivek (telaprevir). Use in combination with Kaletra is not recommended.
- Inhaled or intranasal steroids: Uceris and similar brands. Use in combination is not recommended unless the potential benefit outweighs the risk of increased steroid concentrations and reduced serum cortisol concentrations.
- PDE5 inhibitors: Stendra (avanafil). Do not combine the drugs, because a safe and effective dose of avanafil has not yet been established.
- Studies show no clinically significant interaction between Kaletra and Isentress (raltegravir).