Drug interactions
Hydrocortisone + Ritonavir
Severity: Moderate
Hydrocortisone 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 strongly inhibits CYP3A4 and P-glycoprotein, which raises systemic hydrocortisone exposure. Prolonged use can lead to Cushingoid features, adrenal suppression and hyperglycemia. Hydrocortisone may also modestly lower ritonavir exposure, but this is of limited importance.
What this interaction means in plain words
Hydrocortisone 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.
Hydrocortisone belongs to Endocrine; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir inhibits CYP3A4 metabolism and P-gp efflux of hydrocortisone, increasing its systemic exposure.
What to do
Monitor for glucocorticoid excess (hyperglycemia, fluid retention, Cushingoid signs) with prolonged co-use and consider reducing the hydrocortisone dose. For long-term therapy, consider an alternative corticosteroid less dependent on CYP3A4, or review the need for replacement dosing.
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 Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone Major
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 Hydrocortisone with Ritonavir?
MediHelp rates the interaction as moderate. Hydrocortisone 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 strongly inhibits CYP3A4 and P-glycoprotein, which raises systemic hydrocortisone exposure. Prolonged use can lead to Cushingoid features, adrenal suppression and hyperglycemia. Hydrocortisone may also modestly lower ritonavir exposure, but this is of limited importance.
How serious is the interaction between Hydrocortisone 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: Monitor for glucocorticoid excess (hyperglycemia, fluid retention, Cushingoid signs) with prolonged co-use and consider reducing the hydrocortisone dose. For long-term therapy, consider an alternative corticosteroid less dependent on CYP3A4, or review the need for replacement dosing.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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