Drug interactions
Brexpiprazole + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Major
Brexpiprazole and Ombitasvir / paritaprevir / ritonavir and dasabuvir: major interaction.
Last updated Sources: US FDA label
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
Ritonavir in this regimen strongly inhibits CYP3A4 and can raise brexpiprazole exposure substantially. This increases the risk of dose-related adverse effects such as akathisia, sedation and orthostasis.
What this interaction means in plain words
Brexpiprazole and Ombitasvir / paritaprevir / ritonavir and dasabuvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Ritonavir-mediated strong CYP3A4 inhibition reduces brexpiprazole clearance.
What to do
Give half of the usual brexpiprazole dose, or a quarter if a CYP2D6 inhibitor is also used, and monitor for adverse effects. Restore the dose after the antiviral course ends.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as major. Brexpiprazole and Ombitasvir / paritaprevir / ritonavir and dasabuvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ritonavir in this regimen strongly inhibits CYP3A4 and can raise brexpiprazole exposure substantially. This increases the risk of dose-related adverse effects such as akathisia, sedation and orthostasis.
How serious is the interaction between Brexpiprazole and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give half of the usual brexpiprazole dose, or a quarter if a CYP2D6 inhibitor is also used, and monitor for adverse effects. Restore the dose after the antiviral course ends.
What other medicines interact with Brexpiprazole?
MediHelp also lists interactions of Brexpiprazole with, for example, Alfentanil, Amisulpride, Apalutamide. The full list is on the Brexpiprazole page.
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