Drug interactions
Amiodarone + Nirmatrelvir
Severity: Contraindicated
Amiodarone and Nirmatrelvir: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Nirmatrelvir is given with ritonavir, a strong CYP3A4 inhibitor. Amiodarone levels may rise sharply, risking QT prolongation, bradycardia and torsades de pointes.
What this interaction means in plain words
Amiodarone and Nirmatrelvir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Amiodarone belongs to Cardiovascular; Nirmatrelvir belongs to Anti Virals.
Why it happens
Ritonavir-boosted nirmatrelvir inhibits CYP3A4, reducing amiodarone clearance.
What to do
Avoid the combination and choose an alternative COVID-19 therapy. If use cannot be avoided, seek specialist advice and monitor ECG.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Other interactions of Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
- Enzalutamide + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Amiodarone with Nirmatrelvir?
MediHelp rates the interaction as contraindicated. Amiodarone and Nirmatrelvir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Nirmatrelvir is given with ritonavir, a strong CYP3A4 inhibitor. Amiodarone levels may rise sharply, risking QT prolongation, bradycardia and torsades de pointes.
How serious is the interaction between Amiodarone and Nirmatrelvir?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and choose an alternative COVID-19 therapy. If use cannot be avoided, seek specialist advice and monitor ECG.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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