Drug interactions
Nevirapine + Nirmatrelvir / ritonavir
Severity: Moderate
Nevirapine and Nirmatrelvir / 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 may raise nevirapine exposure and nevirapine may lower nirmatrelvir and ritonavir levels. A short course of nirmatrelvir/ritonavir is usually tolerated, but net effects are uncertain.
What this interaction means in plain words
Nevirapine and Nirmatrelvir / 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.
Why it happens
Ritonavir inhibits CYP3A4 and nevirapine induces CYP3A4, producing opposing effects.
What to do
Monitor for nevirapine toxicity such as rash and hepatotoxicity during the five-day course; no routine dose change is needed.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Nevirapine with Nirmatrelvir / ritonavir?
MediHelp rates the interaction as moderate. Nevirapine and Nirmatrelvir / 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 may raise nevirapine exposure and nevirapine may lower nirmatrelvir and ritonavir levels. A short course of nirmatrelvir/ritonavir is usually tolerated, but net effects are uncertain.
How serious is the interaction between Nevirapine and Nirmatrelvir / 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: Monitor for nevirapine toxicity such as rash and hepatotoxicity during the five-day course; no routine dose change is needed.
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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