Drug interactions
Nifedipine + Nirmatrelvir
Severity: Moderate
Nifedipine and Nirmatrelvir: 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
Nirmatrelvir is co-packaged with ritonavir, a strong CYP3A4 inhibitor, which can substantially raise nifedipine exposure. This may cause excessive hypotension, flushing, headache and peripheral edema during and shortly after the 5-day course.
What this interaction means in plain words
Nifedipine and Nirmatrelvir 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.
Nifedipine belongs to Cardiovascular; Nirmatrelvir belongs to Anti Virals.
Why it happens
Ritonavir-boosted nirmatrelvir inhibits CYP3A4-mediated first-pass and hepatic metabolism of nifedipine.
What to do
Monitor blood pressure and heart rate closely during treatment and consider a temporary nifedipine dose reduction. Advise patients to report dizziness or marked swelling.
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 Nifedipine
Other interactions of Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Nifedipine with Nirmatrelvir?
MediHelp rates the interaction as moderate. Nifedipine and Nirmatrelvir 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. Nirmatrelvir is co-packaged with ritonavir, a strong CYP3A4 inhibitor, which can substantially raise nifedipine exposure. This may cause excessive hypotension, flushing, headache and peripheral edema during and shortly after the 5-day course.
How serious is the interaction between Nifedipine and Nirmatrelvir?
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 blood pressure and heart rate closely during treatment and consider a temporary nifedipine dose reduction. Advise patients to report dizziness or marked swelling.
What other medicines interact with Nifedipine?
MediHelp also lists interactions of Nifedipine with, for example, Amifostine, Amlodipine-benazepril, Apalutamide. The full list is on the Nifedipine page.
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