Gemfibrozil and Lopinavir: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Gemfibrozil
Lopinavir
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced gemfibrozil exposure and increased triglyceride levels
Interaction Deep Dive
The administration of a single 600-mg dose of gemfibrozil after a 2-week course of lopinavir/ritonavir significantly decreased gemfibrozil exposure compared with gemfibrozil alone and resulted in increased triglyceride levels in one pharmacokinetic study in 15 healthy volunteers1; therefore, use caution when if these agents are taken together. If gemfibrozil and lopinavir/ritonavir are coadministered, monitor triglyceride levels closely.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) In an open-label pharmacokinetic study in healthy adult volunteers (n=15), the coadministration of gemfibrozil and lopinavir/ritonavir resulted in significantly decreased gemfibrozil AUC and Cmax values and increased triglyceride levels. HIV-negative subjects (average age, 37 +/- 10 years) who had fasting total cholesterol and triglyceride levels below 270 mg/dL received a single 600-mg dose of gemfibrozil before starting lopinavir 400 mg/ritonavir 100 mg twice daily and then a single 600-mg dose of gemfibrozil 14 days after starting lopinavir/ritonavir. The mean gemfibrozil AUC decreased 41% from 104 to 62 mcg x hr/mL (geometric mean ratio (GMR), 0.59; 90% CI, 0.52 to 0.67; p=0.001) and the mean Cmax decreased from 28 to 19 mcg/mL (GMR, 0.67; 90% CI, 0.49 to 0.86; p=0.01) when gemfibrozil was administered with lopinavir/ritonavir; however, the Tmax and half-life values were not significantly different. Additionally, the mean triglyceride levels increased by 73% (from 77 mg/dL pre-lopinavir/ritonavir to 133 mg/dL post-lopinavir/ritonavir) when gemfibrozil was given with lopinavir/ritonavir 1.
Common questions
Can I take Gemfibrozil and Lopinavir together?
Reduced gemfibrozil exposure and increased triglyceride levels Always confirm with your pharmacist or prescriber before making any change.
How serious is the Gemfibrozil and Lopinavir interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
Questions for your pharmacist
- Does my dose of Gemfibrozil or Lopinavir need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Busse KH, Hadigan C, Chairez C, et al: Gemfibrozil concentrations are significantly decreased in the presence of lopinavir-ritonavir. J Acquir Immune Defic Syndr 2009; 52(2):235-239. PubMed
Keep reading about Gemfibrozil
Keep reading about Lopinavir
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