Drug interactions
Lurasidone + Nirmatrelvir / ritonavir
Severity: Contraindicated
Lurasidone and Nirmatrelvir / ritonavir: contraindicated 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-boosted nirmatrelvir strongly inhibits CYP3A4 and is expected to substantially raise lurasidone concentrations. This increases the risk of sedation, extrapyramidal symptoms and other dose-related toxicity. The combination is contraindicated.
What this interaction means in plain words
Lurasidone and Nirmatrelvir / ritonavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Ritonavir-mediated strong inhibition of CYP3A4 decreases lurasidone metabolism.
What to do
Do not coadminister; use an alternative COVID-19 antiviral or temporarily switch to an antipsychotic not dependent on CYP3A4.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
Other interactions of Lurasidone
- Apalutamide + Lurasidone Contraindicated
- Atazanavir + Lurasidone Contraindicated
- Carbamazepine + Lurasidone Contraindicated
- Clarithromycin + Lurasidone Contraindicated
- Cobicistat + Lurasidone Contraindicated
- Conivaptan + Lurasidone Contraindicated
Frequently asked questions
Can I take Lurasidone with Nirmatrelvir / ritonavir?
MediHelp rates the interaction as contraindicated. Lurasidone and Nirmatrelvir / ritonavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ritonavir-boosted nirmatrelvir strongly inhibits CYP3A4 and is expected to substantially raise lurasidone concentrations. This increases the risk of sedation, extrapyramidal symptoms and other dose-related toxicity. The combination is contraindicated.
How serious is the interaction between Lurasidone and Nirmatrelvir / ritonavir?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister; use an alternative COVID-19 antiviral or temporarily switch to an antipsychotic not dependent on CYP3A4.
What other medicines interact with Lurasidone?
MediHelp also lists interactions of Lurasidone with, for example, Apalutamide, Atazanavir, Carbamazepine. The full list is on the Lurasidone page.
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