Drug interactions
Dabigatran etexilate + Ritonavir
Severity: Major
Dabigatran etexilate and Ritonavir: major 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
Ritonavir inhibits P-glycoprotein and may raise dabigatran levels, increasing bleeding risk, especially with reduced kidney function. Ritonavir effects on P-gp can also be mixed after prolonged use.
What this interaction means in plain words
Dabigatran etexilate 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.
Dabigatran etexilate belongs to Cardiovascular; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir inhibits intestinal P-glycoprotein efflux of dabigatran etexilate, increasing exposure.
What to do
Avoid in patients with renal impairment and consider an alternative anticoagulant; otherwise monitor for bleeding and renal function and reduce the dabigatran dose per local labeling.
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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Other interactions of Dabigatran etexilate
- Dabigatran etexilate + Defibrotide Contraindicated
- Dabigatran etexilate + Ketorolac Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
- Abciximab + Dabigatran etexilate Major
- Alteplase + Dabigatran etexilate Major
- Amiodarone + Dabigatran etexilate Major
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 Dabigatran etexilate with Ritonavir?
MediHelp rates the interaction as major. Dabigatran etexilate 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 inhibits P-glycoprotein and may raise dabigatran levels, increasing bleeding risk, especially with reduced kidney function. Ritonavir effects on P-gp can also be mixed after prolonged use.
How serious is the interaction between Dabigatran etexilate 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: Avoid in patients with renal impairment and consider an alternative anticoagulant; otherwise monitor for bleeding and renal function and reduce the dabigatran dose per local labeling.
What other medicines interact with Dabigatran etexilate?
MediHelp also lists interactions of Dabigatran etexilate with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dabigatran etexilate page.
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