Drug interactions
Nifedipine + Ritonavir
Severity: Major
Nifedipine 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 is a strong CYP3A4 inhibitor and can markedly increase nifedipine concentrations, leading to hypotension, edema, tachycardia and headache. The effect of nifedipine on ritonavir is not clinically meaningful.
What this interaction means in plain words
Nifedipine 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.
Nifedipine belongs to Cardiovascular; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir inhibits CYP3A4 metabolism of nifedipine in the gut wall and liver.
What to do
Start nifedipine at the lowest dose and titrate by blood pressure response, or choose an alternative antihypertensive with less CYP3A4 dependence. Monitor blood pressure and edema throughout.
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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Other interactions of Nifedipine
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 Nifedipine with Ritonavir?
MediHelp rates the interaction as major. Nifedipine 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 markedly increase nifedipine concentrations, leading to hypotension, edema, tachycardia and headache. The effect of nifedipine on ritonavir is not clinically meaningful.
How serious is the interaction between Nifedipine 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: Start nifedipine at the lowest dose and titrate by blood pressure response, or choose an alternative antihypertensive with less CYP3A4 dependence. Monitor blood pressure and edema throughout.
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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