Drug interactions
Delamanid + Ritonavir
Severity: Major
Delamanid 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 strongly inhibits CYP3A4 and modestly raises exposure to the delamanid metabolite DM-6705. Higher DM-6705 levels are associated with QT prolongation, and ritonavir-boosted regimens are often given with other QT-active drugs.
What this interaction means in plain words
Delamanid 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.
Delamanid belongs to Anti Bacterial; Ritonavir belongs to Anti Virals.
Why it happens
CYP3A4 inhibition by ritonavir reduces clearance of the delamanid metabolite DM-6705, increasing QT-prolonging exposure.
What to do
Perform frequent ECG monitoring from the start and throughout co-administration, and check potassium, magnesium and calcium. Avoid additional QT-prolonging drugs where possible.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Delamanid and Ritonavir, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Delamanid
- Carbamazepine + Delamanid Contraindicated
- Delamanid + Rifampicin Contraindicated
- Delamanid + Moxifloxacin Major
- Delamanid + Ethambutol Minor
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 Delamanid with Ritonavir?
MediHelp rates the interaction as major. Delamanid 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 modestly raises exposure to the delamanid metabolite DM-6705. Higher DM-6705 levels are associated with QT prolongation, and ritonavir-boosted regimens are often given with other QT-active drugs.
How serious is the interaction between Delamanid 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: Perform frequent ECG monitoring from the start and throughout co-administration, and check potassium, magnesium and calcium. Avoid additional QT-prolonging drugs where possible.
What other medicines interact with Delamanid?
MediHelp also lists interactions of Delamanid with, for example, Carbamazepine, Rifampicin, Moxifloxacin. The full list is on the Delamanid page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
