Drug General Information (ID: DDI48CIGNB)
  Drug Name Lopinavir Drug Info Hydroxychloroquine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anti-Hiv Agents Antimalarial Agents
  Structure

 Mechanism of Lopinavir-Hydroxychloroquine Interaction (Severity Level: Major)
     Increased risk of prolong QT interval Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Lopinavir Hydroxychloroquine
      Mechanism Prolong QT interval Prolong QT interval
      Key Mechanism Factor 1
Factor Name QT interval
Factor Description Long QT syndrome is a heart signaling disorder that can cause a fast, chaotic heartbeat (arrhythmia). Many people may not exhibit symptoms, and usually the condition is detected during routine medical tests. In others, the most common symptoms include: sudden fainting, palpitations, dizziness, seizures, sudden death.
      Mechanism Description
  • Increased risk of prolong QT interval by the combination of Lopinavir and Hydroxychloroquine 

Recommended Action
      Management Coadministration of chloroquine or hydroxychloroquine with other drugs that can prolong the QT interval should generally be avoided, particularly in patients with baseline QT prolongation (e.g., QTc >=500 msec) or congenital long QT syndrome. Close monitoring of QTc interval, electrolyte levels, and renal and hepatic function is recommended if concomitant use is required and benefits are anticipated to outweigh the risks. Electrolyte abnormalities should be corrected prior to initiating treatment with chloroquine or hydroxychloroquine. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. Because chloroquine and hydroxychloroquine are eliminated slowly from the body, the potential for drug interactions should be observed for a prolonged period following their discontinuation.

References
1 Product Information. Hydroxychloroquine Sulfate (hydroxychloroquine). Prasco Laboratories, Cincinnati, OH.
2 Mercuro NJ, Yen CF, Shim DJ, et.al "Risk of QT interval prolongation associated with the use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for coronavirus disease 2019 (COVID-19)" JAMA Cardiol May 1:e201834 (2020): epub ahead of print. [PMID: 32936252]
3 US Food and Drug Administration "FACT SHEET FOR HEALTH CARE PROVIDERS EMERGENCY USE AUTHORIZATION (EUA) OF CHLOROQUINE PHOSPHATE SUPPLIED FROM THE STRATEGIC NATIONAL STOCKPILE FOR TREATMENT OF COVID-19 IN CERTAIN HOSPITALIZED PATIENTS. Available from: URL: https://www.fda.gov/media/13653" ([2020, Apr 27]):.