Drug interactions
Netupitant-palonosetron + Ritonavir
Severity: Moderate
Netupitant-palonosetron and Ritonavir: moderate 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 is a strong CYP3A4 inhibitor and can raise netupitant exposure, since netupitant is cleared mainly by CYP3A4. The higher netupitant levels may increase the chance of adverse effects such as headache, constipation and fatigue. Netupitant itself also inhibits CYP3A4, which may further raise ritonavir exposure.
What this interaction means in plain words
Netupitant-palonosetron and Ritonavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Netupitant-palonosetron belongs to Gastrointestinal Tract; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir inhibits CYP3A4-mediated metabolism of netupitant, increasing its plasma concentrations.
What to do
No routine dose adjustment of the single-dose antiemetic is needed, but monitor for netupitant adverse effects. Watch for increased antiretroviral adverse effects during repeated courses.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Netupitant-palonosetron
- Apomorphine + Netupitant-palonosetron Contraindicated
- Flibanserin + Netupitant-palonosetron Contraindicated
- Apalutamide + Netupitant-palonosetron Major
- Avapritinib + Netupitant-palonosetron Major
- Carbamazepine + Netupitant-palonosetron Major
- Cobimetinib + Netupitant-palonosetron 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 Netupitant-palonosetron with Ritonavir?
MediHelp rates the interaction as moderate. Netupitant-palonosetron and Ritonavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ritonavir is a strong CYP3A4 inhibitor and can raise netupitant exposure, since netupitant is cleared mainly by CYP3A4. The higher netupitant levels may increase the chance of adverse effects such as headache, constipation and fatigue. Netupitant itself also inhibits CYP3A4, which may further raise ritonavir exposure.
How serious is the interaction between Netupitant-palonosetron and Ritonavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose adjustment of the single-dose antiemetic is needed, but monitor for netupitant adverse effects. Watch for increased antiretroviral adverse effects during repeated courses.
What other medicines interact with Netupitant-palonosetron?
MediHelp also lists interactions of Netupitant-palonosetron with, for example, Apomorphine, Flibanserin, Apalutamide. The full list is on the Netupitant-palonosetron page.
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