Drug interactions
Macitentan + Nevirapine
Severity: Major
Macitentan and Nevirapine: 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
Nevirapine may lower macitentan and its active metabolite concentrations, reducing efficacy in pulmonary arterial hypertension. Strong CYP3A4 inducers markedly reduce macitentan exposure.
What this interaction means in plain words
Macitentan and Nevirapine 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.
Macitentan belongs to Cardiovascular; Nevirapine belongs to Anti Virals.
Why it happens
CYP3A4 induction by nevirapine increases macitentan metabolism.
What to do
Avoid the combination and use an alternative antiretroviral if possible. If it is required, monitor for worsening pulmonary hypertension symptoms.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Other interactions of Macitentan
- Amiodarone + Macitentan Major
- Apalutamide + Macitentan Major
- Bosentan + Macitentan Major
- Carbamazepine + Macitentan Major
- Clarithromycin + Macitentan Major
- Efavirenz + Macitentan Major
Frequently asked questions
Can I take Macitentan with Nevirapine?
MediHelp rates the interaction as major. Macitentan and Nevirapine 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. Nevirapine may lower macitentan and its active metabolite concentrations, reducing efficacy in pulmonary arterial hypertension. Strong CYP3A4 inducers markedly reduce macitentan exposure.
How serious is the interaction between Macitentan and Nevirapine?
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 the combination and use an alternative antiretroviral if possible. If it is required, monitor for worsening pulmonary hypertension symptoms.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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