Drug interactions
Ivosidenib + Ritonavir
Severity: Major
Ivosidenib and Ritonavir: major interaction.
Last updated Sources: US FDA label
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 increases ivosidenib exposure and may heighten the risk of QT prolongation and differentiation syndrome. The effect is clinically significant due to ivosidenib's QT liability.
What this interaction means in plain words
Ivosidenib 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.
Ivosidenib belongs to Oncology; Ritonavir belongs to Anti Virals.
Why it happens
Strong CYP3A4 inhibition by ritonavir reduces ivosidenib metabolism.
What to do
Avoid if possible; otherwise reduce ivosidenib to 250 mg daily and monitor ECG and electrolytes.
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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References
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 Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Ivosidenib with Ritonavir?
MediHelp rates the interaction as major. Ivosidenib 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 increases ivosidenib exposure and may heighten the risk of QT prolongation and differentiation syndrome. The effect is clinically significant due to ivosidenib's QT liability.
How serious is the interaction between Ivosidenib 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 if possible; otherwise reduce ivosidenib to 250 mg daily and monitor ECG and electrolytes.
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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