洛匹那韋/利托那韋主要用于人類免疫缺陷（艾滋病）病毒感染的治療，臨床上超說明書用于新型冠狀病毒感染的治療。臨床發(fā)現(xiàn)使用該藥后易引發(fā)多種不良反應(yīng)，主要包括胃腸道反應(yīng)、肝損傷、代謝紊亂、心血管和神經(jīng)毒性不良反應(yīng)。洛匹那韋/利托那韋不良反應(yīng)機(jī)制可能與內(nèi)質(zhì)網(wǎng)應(yīng)激、氧化應(yīng)激、線粒體應(yīng)激、細(xì)胞凋亡等有關(guān)，具有劑量相關(guān)性，劑量越高則不良反應(yīng)越大，主要由肝臟CYP3A代謝，當(dāng)其與某些具有較強(qiáng)CYP3A4抑制作用的藥物共同使用時(shí)，往往會(huì)加重其不良反應(yīng)。綜述了洛匹那韋/利托那韋片的不良反應(yīng)及其發(fā)生機(jī)制，為臨床安全、合理用藥提供參考。

Lopinavir/ritonavir is mainly used in treatment of HIV/AIDS infection, and it has also been reported that off-label use in COVID-19 clinical research. A variety of adverse reactions of lopinavir/ritonavir were caused after clinical use, mainly including gastrointestinal reaction, liver injury, metabolic disorder, cardiovascular and neurotoxicity, and so on. The adverse reaction mechanism of lopinavir/ritonavir may be related to endoplasmic reticulum stress, oxidative stress, mitochondrial stress, cell apoptosis, etc. Lopinavir/ritonavir has a dose-dependent relationship, and the higher the dose, the greater the adverse reaction. Lopinavir/ritonavir is mainly metabolized by liver CYP3A. When used together with some drugs with strong CYP3A4 inhibition, it often aggravates its adverse reactions. This article reviews the adverse reactions of lopinavir/ritonavir and their mechanisms, providing reference for clinical safe and rational use of drugs.

R977

畢節(jié)市應(yīng)急計(jì)劃項(xiàng)目（畢科合字[2022]01號(hào)）；畢節(jié)市聯(lián)合基金項(xiàng)目（畢科聯(lián)合字sy[2022]10號(hào)）；畢節(jié)市個(gè)體化用藥人才團(tuán)隊(duì)項(xiàng)目