Drug interactions
Ibrutinib + Ritonavir
Severity: Major
Ibrutinib and 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 markedly increases ibrutinib exposure through CYP3A4 inhibition. Higher levels raise the risk of bleeding, arrhythmias, infection and cytopenias.
What this interaction means in plain words
Ibrutinib and 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.
Ibrutinib belongs to Oncology; Ritonavir belongs to Anti Virals.
Why it happens
Strong CYP3A4 inhibition by ritonavir decreases ibrutinib first-pass and systemic metabolism.
What to do
Avoid coadministration where possible. If unavoidable, reduce the ibrutinib dose per labeling and monitor for toxicity.
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 Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Other interactions of Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Ibrutinib with Ritonavir?
MediHelp rates the interaction as major. Ibrutinib and 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 markedly increases ibrutinib exposure through CYP3A4 inhibition. Higher levels raise the risk of bleeding, arrhythmias, infection and cytopenias.
How serious is the interaction between Ibrutinib and 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: Avoid coadministration where possible. If unavoidable, reduce the ibrutinib dose per labeling and monitor for toxicity.
What other medicines interact with Ritonavir?
MediHelp also lists interactions of Ritonavir with, for example, Alfuzosin, Amiodarone, Avanafil. The full list is on the Ritonavir page.
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