Drug interactions
Escitalopram + Ritonavir
Severity: Moderate
Escitalopram and Ritonavir: moderate 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 CYP3A4 and can raise escitalopram concentrations, increasing QT prolongation and serotonergic adverse effects. The effect is limited because escitalopram is also cleared by CYP2C19.
What this interaction means in plain words
Escitalopram and Ritonavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Escitalopram belongs to Central Nervous System; Ritonavir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4-mediated escitalopram metabolism by ritonavir.
What to do
Use the lowest effective escitalopram dose and monitor for serotonin toxicity and QT prolongation. Obtain an ECG if risk factors are present.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
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 Escitalopram with Ritonavir?
MediHelp rates the interaction as moderate. Escitalopram and Ritonavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ritonavir inhibits CYP3A4 and can raise escitalopram concentrations, increasing QT prolongation and serotonergic adverse effects. The effect is limited because escitalopram is also cleared by CYP2C19.
How serious is the interaction between Escitalopram and Ritonavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective escitalopram dose and monitor for serotonin toxicity and QT prolongation. Obtain an ECG if risk factors are present.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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