洛匹那韦/利托那韦主要用于人类免疫缺陷（艾滋病）病毒感染的治疗，临床上超说明书用于新型冠状病毒感染的治疗。临床发现使用该药后易引发多种不良反应，主要包括胃肠道反应、肝损伤、代谢紊乱、心血管和神经毒性不良反应。洛匹那韦/利托那韦不良反应机制可能与内质网应激、氧化应激、线粒体应激、细胞凋亡等有关，具有剂量相关性，剂量越高则不良反应越大，主要由肝脏CYP3A代谢，当其与某些具有较强CYP3A4抑制作用的药物共同使用时，往往会加重其不良反应。综述了洛匹那韦/利托那韦片的不良反应及其发生机制，为临床安全、合理用药提供参考。

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

毕节市应急计划项目（毕科合字[2022]01号）；毕节市联合基金项目（毕科联合字sy[2022]10号）；毕节市个体化用药人才团队项目