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Drug Interactions between AccessPak for HIV PEP Expanded with Kaletra and st. john's wort

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

ritonavir St. John's wort

Applies to: AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir) and st. john's wort

Using ritonavir together with St. John's wort is not recommended. Combining these medications may significantly reduce the blood levels of ritonavir, which may make it less effective in treating HIV infection. Additionally, it may lead to development of viral resistance to this and various other HIV medications that are currently used for treatment. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. 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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Major

St. John's wort lopinavir

Applies to: st. john's wort and AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir)

Using lopinavir together with St. John's wort is not recommended. Combining these medications may significantly reduce the blood levels of lopinavir, which may make it less effective in treating HIV infection. Additionally, it may lead to development of viral resistance to this and various other HIV medications that are currently used for treatment. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. 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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Major

St. John's wort tenofovir

Applies to: st. john's wort and AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir)

St. John's wort may significantly reduce the blood levels of tenofovir from certain preparations, which may make it less effective in treating your condition. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring 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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Moderate

ritonavir tenofovir

Applies to: AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir) and AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir)

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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Moderate

lopinavir tenofovir

Applies to: AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir) and AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir)

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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Drug and food interactions

Moderate

ritonavir food

Applies to: AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir)

Ritonavir should be taken with food to lessen gastrointestinal side effects. It is important that you take this medication exactly as prescribed by your doctor. Do not change your treatment or stop treatment without first talking to your doctor.

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Moderate

St. John's wort food

Applies to: st. john's wort

While you are taking St. John's wort, you must not eat or drink certain foods and beverages that are high in tyramine. Eating these foods while you are taking St. John's wort can raise your blood pressure to dangerous levels. This may cause life threatening symptoms such as sudden and severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, seizure (convulsions), and sudden numbness or weakness (especially on one side of the body). Call your doctor at once if you have any of these symptoms. Foods that are high in tyramine include: air dried meats, aged or fermented meats, sausage or salami, pickled herring, and any spoiled or improperly stored beef, poultry, fish, or liver, red wine, beer from a tap, beer that has not been pasteurize, aged cheeses, including blue, brick, brie, cheddar, parmesan, romano, and swiss, sauerkraut, over the counter supplements or cough and cold medicines that contain tyramine, soy beans, soy sauce, tofu, miso soup, bean curd, fava beans, or yeast extracts (such as Marmite). Caffeine intake should be limited as well. You should avoid or limit the use of alcohol while being treated with St. John's wort. Alcohol can increase the nervous system side effects of St. John's wort such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

lopinavir food

Applies to: AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir)

Food may affect the absorption of lopinavir-ritonavir (brand name Kaletra) depending on whether you are taking the oral solution or the tablet. The oral solution should be taken with food to enhance absorption and help it work better. The tablet formulation can be take with or without food. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. 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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Minor

tenofovir food

Applies to: AccessPak for HIV PEP Expanded with Kaletra (emtricitabine / lopinavir / ritonavir / tenofovir)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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