Drug interactions
Midostaurin + Ritonavir
Severity: Major
Midostaurin and Ritonavir: major interaction.
Last updated Sources: Health Canada product monograph
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 is a strong CYP3A4 inhibitor and can substantially raise midostaurin exposure. This may increase adverse reactions such as nausea, infections and QT effects, especially early in treatment.
What this interaction means in plain words
Midostaurin 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.
Midostaurin belongs to Oncology; Ritonavir belongs to Anti Virals.
Why it happens
CYP3A4 inhibition reduces midostaurin metabolism, increasing its plasma concentrations.
What to do
Consider an alternative antiretroviral without strong CYP3A inhibition. If combined, monitor closely for toxicity, particularly in the first week, including ECG monitoring.
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 Midostaurin
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 Midostaurin with Ritonavir?
MediHelp rates the interaction as major. Midostaurin 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 is a strong CYP3A4 inhibitor and can substantially raise midostaurin exposure. This may increase adverse reactions such as nausea, infections and QT effects, especially early in treatment.
How serious is the interaction between Midostaurin 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: Consider an alternative antiretroviral without strong CYP3A inhibition. If combined, monitor closely for toxicity, particularly in the first week, including ECG monitoring.
What other medicines interact with Midostaurin?
MediHelp also lists interactions of Midostaurin with, for example, Alfuzosin, Amisulpride, Amobarbital. The full list is on the Midostaurin page.
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