Lopinavir-ritonavir is a potential treatment for SARS-CoV-2 that inhibits cytochrome P450 3A4 and interacts with cardiac medications. Ritonavir specifically inhibits CYP3A4 and CYP2D6 while inducing CYP2B6, CYP2C19, CYP2C9, and CYP1A2. The document provides key recommendations on the drug-drug interactions between lopinavir-ritonavir and cardiac medications based on these metabolic effects.

1. Lopinavir-Ritonavir in SARS-CoV-2 Infection and
Drug-Drug
Interactions with Cardioactive Medications
Sanjeev Kumar Agarwal
MBBS, MD, DM, FACC, CBCCT
Consultant Cardiologist
Rashid Hospital, Dubai
UAE

2. Ritonavir
• A potent inhibitor of cytochrome (CYP) P450 3A4
• Inhibits CYP2D6
• Induces CYP2B6, CYP2C19, CYP2C9, and CYP1A2.

3. Key recommendations based on drug-drug interactions of
lopinavir-ritonavir and cardiac medications

4. Key recommendations based on drug-drug interactions
of lopinavir-ritonavir and cardiac medications

5. Full text
Lopinavir-Ritonavir in SARS-CoV-2 Infection and Drug-
Drug Interactions with Cardioactive Medications
Cardiovascular Drugs and Therapy
https://doi.org/10.1007/s10557-020-07070-1
https://pubmed.ncbi.nlm.nih.gov/32918656/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486
594/