Drug interactions
Liposomal doxorubicin + Ritonavir
Severity: Moderate
Liposomal doxorubicin 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 inhibits CYP3A4 and P-glycoprotein and may increase doxorubicin exposure, raising the risk of myelosuppression, mucositis and cardiotoxicity. The effect with the liposomal form is not well defined.
What this interaction means in plain words
Liposomal doxorubicin 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.
Liposomal doxorubicin belongs to Oncology; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir inhibits CYP3A4 and P-gp, reducing doxorubicin metabolism and efflux.
What to do
Monitor blood counts and signs of mucositis, palmar-plantar erythrodysesthesia and cardiac toxicity. Consider dose reduction if toxicity develops.
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 Liposomal doxorubicin
- Dengue vaccine + Liposomal doxorubicin Contraindicated
- Belatacept + Liposomal doxorubicin Major
- Cyclosporine + Liposomal doxorubicin Major
- Dronedarone + Liposomal doxorubicin Major
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Liposomal doxorubicin Major
- Fingolimod + Liposomal doxorubicin 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 Liposomal doxorubicin with Ritonavir?
MediHelp rates the interaction as moderate. Liposomal doxorubicin 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 inhibits CYP3A4 and P-glycoprotein and may increase doxorubicin exposure, raising the risk of myelosuppression, mucositis and cardiotoxicity. The effect with the liposomal form is not well defined.
How serious is the interaction between Liposomal doxorubicin 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 blood counts and signs of mucositis, palmar-plantar erythrodysesthesia and cardiac toxicity. Consider dose reduction if toxicity develops.
What other medicines interact with Liposomal doxorubicin?
MediHelp also lists interactions of Liposomal doxorubicin with, for example, Dengue vaccine, Belatacept, Cyclosporine. The full list is on the Liposomal doxorubicin page.
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