Drug interactions
Ciclesonide + Ritonavir
Severity: Major
Ciclesonide and Ritonavir: 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 strongly inhibits CYP3A4 and can substantially raise systemic levels of inhaled ciclesonide. Cushing's syndrome and adrenal suppression have been reported with ritonavir plus inhaled corticosteroids that are CYP3A4 substrates.
What this interaction means in plain words
Ciclesonide 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.
Ciclesonide belongs to Respiratory; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir strongly inhibits CYP3A4, decreasing metabolic clearance of ciclesonide and its active metabolite.
What to do
Prefer beclomethasone or another less CYP3A4-dependent corticosteroid in patients on ritonavir-boosted regimens. If coadministered, use the lowest effective dose and monitor for Cushing's features and adrenal suppression.
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 Ciclesonide
- Apalutamide + Ciclesonide Moderate
- Atazanavir + Ciclesonide Moderate
- Ceritinib + Ciclesonide Moderate
- Ciclesonide + Clarithromycin Moderate
- Ciclesonide + Cobicistat Moderate
- Ciclesonide + Darunavir Moderate
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 Ciclesonide with Ritonavir?
MediHelp rates the interaction as major. Ciclesonide 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 strongly inhibits CYP3A4 and can substantially raise systemic levels of inhaled ciclesonide. Cushing's syndrome and adrenal suppression have been reported with ritonavir plus inhaled corticosteroids that are CYP3A4 substrates.
How serious is the interaction between Ciclesonide 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: Prefer beclomethasone or another less CYP3A4-dependent corticosteroid in patients on ritonavir-boosted regimens. If coadministered, use the lowest effective dose and monitor for Cushing's features and adrenal suppression.
What other medicines interact with Ciclesonide?
MediHelp also lists interactions of Ciclesonide with, for example, Apalutamide, Atazanavir, Ceritinib. The full list is on the Ciclesonide page.
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