Drug interactions
Everolimus + Ritonavir
Severity: Contraindicated
Everolimus and Ritonavir: contraindicated 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 P-glycoprotein and can markedly raise everolimus exposure. This increases the risk of mTOR inhibitor toxicity such as infections, myelosuppression, hyperglycemia, hyperlipidemia, stomatitis and pneumonitis.
What this interaction means in plain words
Everolimus and 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.
Everolimus belongs to Oncology; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir inhibits intestinal and hepatic CYP3A4 and P-glycoprotein, reducing everolimus clearance and increasing absorption.
What to do
Avoid concomitant use and select an antiretroviral regimen without strong CYP3A4 inhibition. If unavoidable, use only with specialist oversight, major everolimus dose reduction and therapeutic drug monitoring.
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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Other interactions of Everolimus
- Bcg vaccine live + Everolimus Contraindicated
- Everolimus + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Everolimus + Levoketoconazole Contraindicated
- Everolimus + Measles mumps and rubella vaccine live Contraindicated
- Everolimus + Measles mumps rubella and varicella vaccine live Contraindicated
- Everolimus + Measles vaccine 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 Everolimus with Ritonavir?
MediHelp rates the interaction as contraindicated. Everolimus and 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 strongly inhibits CYP3A4 and P-glycoprotein and can markedly raise everolimus exposure. This increases the risk of mTOR inhibitor toxicity such as infections, myelosuppression, hyperglycemia, hyperlipidemia, stomatitis and pneumonitis.
How serious is the interaction between Everolimus and 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: Avoid concomitant use and select an antiretroviral regimen without strong CYP3A4 inhibition. If unavoidable, use only with specialist oversight, major everolimus dose reduction and therapeutic drug monitoring.
What other medicines interact with Everolimus?
MediHelp also lists interactions of Everolimus with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Levoketoconazole. The full list is on the Everolimus page.
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