Drug interactions
Neratinib + Ritonavir
Severity: Major
Neratinib 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 strongly inhibits CYP3A4 and P-glycoprotein, markedly raising neratinib exposure. This increases the risk of neratinib toxicity, particularly severe diarrhea and hepatotoxicity.
What this interaction means in plain words
Neratinib 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.
Neratinib belongs to Oncology; Ritonavir belongs to Anti Virals.
Why it happens
Strong CYP3A4 and P-gp inhibition by ritonavir reduces neratinib clearance.
What to do
Avoid concomitant use. Consider an alternative antiretroviral regimen without a pharmacokinetic booster.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Neratinib and Ritonavir, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Other interactions of Neratinib
- Amiodarone + Neratinib Major
- Amobarbital + Neratinib Major
- Aprepitant + Neratinib Major
- Armodafinil + Neratinib Major
- Bosentan + Neratinib Major
- Carbamazepine + Neratinib Major
Frequently asked questions
Can I take Neratinib with Ritonavir?
MediHelp rates the interaction as major. Neratinib 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 strongly inhibits CYP3A4 and P-glycoprotein, markedly raising neratinib exposure. This increases the risk of neratinib toxicity, particularly severe diarrhea and hepatotoxicity.
How serious is the interaction between Neratinib 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 concomitant use. Consider an alternative antiretroviral regimen without a pharmacokinetic booster.
What other medicines interact with Ritonavir?
MediHelp also lists interactions of Ritonavir with, for example, Alfuzosin, Amiodarone, Avanafil. The full list is on the Ritonavir page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
