Drug Interactions between emtricitabine / lopinavir / ritonavir / tenofovir and levoketoconazole

Ritonavir may significantly increase the blood levels of levoketoconazole. This can increase the risk of potentially serious and life-threatening cardiovascular side effects and liver problems. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. You should seek immediate medical attention if during treatment with levoketoconazole you develop sudden dizziness, lightheadedness, fainting, shortness of breath, heart palpitations, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, dark colored urine, light-colored stools, or yellowing of the skin or eyes. 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.

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Using lopinavir together with levoketoconazole is not recommended. Combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with either of 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.

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Levoketoconazole may cause liver injury and using it with other medications that can also affect the liver such as tenofovir may increase the risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. 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.

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Levoketoconazole may cause liver injury and using it with other medications that can also affect the liver such as emtricitabine may increase the risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. 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.

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Ritonavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both 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.

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Lopinavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both 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.

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