Drug interactions
Cariprazine + Ritonavir
Severity: Major
Cariprazine and Ritonavir: major interaction.
Last updated Sources: UK SmPC
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 is a potent CYP3A4 inhibitor and can substantially increase cariprazine and active metabolite exposure. This raises the risk of akathisia, extrapyramidal effects, sedation and orthostatic hypotension, persisting for weeks after the inhibitor is stopped.
What this interaction means in plain words
Cariprazine and Ritonavir 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.
Cariprazine belongs to Central Nervous System; Ritonavir belongs to Anti Virals.
Why it happens
Potent CYP3A4 inhibition reduces the clearance of cariprazine and its active metabolites.
What to do
Halve the cariprazine dose (or adjust the dosing schedule per labeling) when starting ritonavir, and monitor for adverse effects. Re-titrate after ritonavir is stopped, allowing for the long washout.
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 Cariprazine
Other interactions of Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Cariprazine with Ritonavir?
MediHelp rates the interaction as major. Cariprazine and Ritonavir 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 is a potent CYP3A4 inhibitor and can substantially increase cariprazine and active metabolite exposure. This raises the risk of akathisia, extrapyramidal effects, sedation and orthostatic hypotension, persisting for weeks after the inhibitor is stopped.
How serious is the interaction between Cariprazine and Ritonavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Halve the cariprazine dose (or adjust the dosing schedule per labeling) when starting ritonavir, and monitor for adverse effects. Re-titrate after ritonavir is stopped, allowing for the long washout.
What other medicines interact with Cariprazine?
MediHelp also lists interactions of Cariprazine with, for example, Alfentanil, Amisulpride, Amobarbital. The full list is on the Cariprazine page.
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