Drug interactions
Felodipine + Nirmatrelvir / ritonavir
Severity: Major
Felodipine and Nirmatrelvir / 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 is a strong CYP3A4 inhibitor and markedly increases felodipine concentrations. This can cause pronounced hypotension, flushing, tachycardia and peripheral edema.
What this interaction means in plain words
Felodipine and Nirmatrelvir / 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.
Why it happens
Ritonavir potently inhibits intestinal and hepatic CYP3A4, reducing first-pass and systemic clearance of felodipine.
What to do
Consider reducing the felodipine dose or temporarily switching to a non-CYP3A4 antihypertensive during the 5-day course and for a few days afterward. Monitor blood pressure and heart rate closely.
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 Felodipine
- Felodipine + Itraconazole Contraindicated
- Aldesleukin + Felodipine Major
- Amifostine + Felodipine Major
- Apalutamide + Felodipine Major
- Atazanavir + Felodipine Major
- Carbamazepine + Felodipine Major
Frequently asked questions
Can I take Felodipine with Nirmatrelvir / ritonavir?
MediHelp rates the interaction as major. Felodipine and Nirmatrelvir / 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 is a strong CYP3A4 inhibitor and markedly increases felodipine concentrations. This can cause pronounced hypotension, flushing, tachycardia and peripheral edema.
How serious is the interaction between Felodipine and Nirmatrelvir / 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: Consider reducing the felodipine dose or temporarily switching to a non-CYP3A4 antihypertensive during the 5-day course and for a few days afterward. Monitor blood pressure and heart rate closely.
What other medicines interact with Felodipine?
MediHelp also lists interactions of Felodipine with, for example, Itraconazole, Aldesleukin, Amifostine. The full list is on the Felodipine page.
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