Drug interactions
Darunavir + Eplerenone
Severity: Major
Darunavir and Eplerenone: 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
Darunavir is usually given with a pharmacokinetic booster (ritonavir or cobicistat) and these are potent CYP3A4 inhibitors. Eplerenone exposure can rise substantially, raising the risk of severe hyperkalemia.
What this interaction means in plain words
Darunavir and Eplerenone 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.
Darunavir belongs to Anti Virals; Eplerenone belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4 reduces eplerenone clearance, particularly with boosted regimens.
What to do
Limit the eplerenone dose as per labeling for moderate or strong CYP3A4 inhibitors, and monitor serum potassium and renal function closely. Consider an alternative agent when a boosted regimen is used.
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 Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Other interactions of Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Eplerenone?
MediHelp rates the interaction as major. Darunavir and Eplerenone 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. Darunavir is usually given with a pharmacokinetic booster (ritonavir or cobicistat) and these are potent CYP3A4 inhibitors. Eplerenone exposure can rise substantially, raising the risk of severe hyperkalemia.
How serious is the interaction between Darunavir and Eplerenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit the eplerenone dose as per labeling for moderate or strong CYP3A4 inhibitors, and monitor serum potassium and renal function closely. Consider an alternative agent when a boosted regimen is used.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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