Drug interactions
Dronedarone + Nirmatrelvir / ritonavir
Severity: Contraindicated
Dronedarone and Nirmatrelvir / ritonavir: contraindicated 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-boosted nirmatrelvir strongly inhibits CYP3A4 and can greatly increase dronedarone exposure. This raises the risk of QT prolongation, bradycardia and serious ventricular arrhythmias.
What this interaction means in plain words
Dronedarone and Nirmatrelvir / ritonavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Strong CYP3A4 inhibition by ritonavir (and nirmatrelvir) decreases dronedarone metabolism.
What to do
Do not co-administer; select an alternative COVID-19 treatment such as one without CYP3A inhibition, and involve a cardiologist if dronedarone interruption is considered.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
Other interactions of Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone Contraindicated
Frequently asked questions
Can I take Dronedarone with Nirmatrelvir / ritonavir?
MediHelp rates the interaction as contraindicated. Dronedarone and Nirmatrelvir / ritonavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ritonavir-boosted nirmatrelvir strongly inhibits CYP3A4 and can greatly increase dronedarone exposure. This raises the risk of QT prolongation, bradycardia and serious ventricular arrhythmias.
How serious is the interaction between Dronedarone and Nirmatrelvir / ritonavir?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; select an alternative COVID-19 treatment such as one without CYP3A inhibition, and involve a cardiologist if dronedarone interruption is considered.
What other medicines interact with Dronedarone?
MediHelp also lists interactions of Dronedarone with, for example, Adagrasib, Amiodarone, Arsenic trioxide. The full list is on the Dronedarone page.
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