Drug interactions
Indinavir + Nifedipine
Severity: Major
Indinavir and Nifedipine: 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
Indinavir strongly inhibits CYP3A4 and can substantially increase nifedipine concentrations, leading to hypotension, reflex tachycardia, flushing and peripheral edema. Effects on indinavir from nifedipine are not clinically important.
What this interaction means in plain words
Indinavir and Nifedipine 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
Indinavir inhibits CYP3A4-mediated first-pass and hepatic metabolism of nifedipine.
What to do
Start nifedipine at the lowest dose and titrate slowly while monitoring blood pressure and heart rate. Consider an alternative antihypertensive less dependent on CYP3A4 if hypotension develops.
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 Nifedipine
Frequently asked questions
Can I take Indinavir with Nifedipine?
MediHelp rates the interaction as major. Indinavir and Nifedipine 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. Indinavir strongly inhibits CYP3A4 and can substantially increase nifedipine concentrations, leading to hypotension, reflex tachycardia, flushing and peripheral edema. Effects on indinavir from nifedipine are not clinically important.
How serious is the interaction between Indinavir and Nifedipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start nifedipine at the lowest dose and titrate slowly while monitoring blood pressure and heart rate. Consider an alternative antihypertensive less dependent on CYP3A4 if hypotension develops.
What other medicines interact with Nifedipine?
MediHelp also lists interactions of Nifedipine with, for example, Amifostine, Amlodipine-benazepril, Apalutamide. The full list is on the Nifedipine page.
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