Bictegravir, emtricitabine, and tenofovir alafenamide and Lopinavir and ritonavir interaction
Bictegravir, emtricitabine, and tenofovir alafenamide and Lopinavir and ritonavir: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Bictegravir, emtricitabine, and tenofovir alafenamide (BIXLENVO) label · effective 2026-08-27
Concomitant administration of BIXLENVO is contraindicated with: dofetilide due to the potential for increased dofetilide plasma concentrations and associated serious and/or life-threatening events. strong CYP3A inducers due to decreased plasma concentrations of BIC and LEN, which may result in the loss of therapeutic effect and development of resistance to BIXLENVO.
Concomitant administration of BIXLENVO is contraindicated with: Dofetilide Strong CYP3A inducers.
Because BIXLENVO is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended ( 7.1 )
Concomitant administration of BIXLENVO with strong CYP3A inducers is contraindicated [see Contraindications (4) ] .
Concomitant administration of BIXLENVO with moderate CYP3A inducers is not recommended.
From the Lopinavir and ritonavir (Kaletra) label · effective 2026-07-23
Patients who exhibit these signs or symptoms should be evaluated and KALETRA and/or other antiretroviral therapy should be suspended as clinically appropriate.
Elevated transaminases with or without elevated bilirubin levels have been reported in HIV-1 mono-infected and uninfected patients as early as 7 days after the initiation of KALETRA in conjunction with other antiretroviral agents.
Antimycobacterial: rifampin ↓ lopinavir Contraindicated due to potential loss of virologic response and possible resistance to KALETRA or to the class of protease inhibitors or other co-administered antiretroviral agents [see Contraindications ( 4 )] .
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.