Drug interactions
Macitentan + Ritonavir
Severity: Major
Macitentan and Ritonavir: 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
Ritonavir raises macitentan exposure, increasing risks of hypotension, anemia and hepatotoxicity.
What this interaction means in plain words
Macitentan 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.
Macitentan belongs to Cardiovascular; Ritonavir belongs to Anti Virals.
Why it happens
Strong CYP3A4 inhibition by ritonavir reduces macitentan clearance.
What to do
Avoid the combination; if unavoidable, monitor blood pressure and hemoglobin closely.
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 Macitentan
- Amiodarone + Macitentan Major
- Apalutamide + Macitentan Major
- Bosentan + Macitentan Major
- Carbamazepine + Macitentan Major
- Clarithromycin + Macitentan Major
- Efavirenz + Macitentan 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 Macitentan with Ritonavir?
MediHelp rates the interaction as major. Macitentan 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 raises macitentan exposure, increasing risks of hypotension, anemia and hepatotoxicity.
How serious is the interaction between Macitentan 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 the combination; if unavoidable, monitor blood pressure and hemoglobin closely.
What other medicines interact with Macitentan?
MediHelp also lists interactions of Macitentan with, for example, Amiodarone, Apalutamide, Bosentan. The full list is on the Macitentan page.
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