Drug interactions
Nirmatrelvir / ritonavir + Prednisone
Severity: Moderate
Nirmatrelvir / ritonavir and Prednisone: 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 strongly inhibits CYP3A4 and can raise systemic corticosteroid exposure. Prednisolone is affected less than other steroids, but prolonged coadministration raises the risk of Cushing syndrome and adrenal suppression.
What this interaction means in plain words
Nirmatrelvir / ritonavir and Prednisone 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, reducing prednisolone clearance.
What to do
For a short course, continue prednisone with monitoring for hyperglycemia and steroid adverse effects. For long-term steroid use, consider a lower dose or an alternative steroid.
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 Prednisone
- Bcg vaccine live + Prednisone Contraindicated
- Measles vaccine + Prednisone Contraindicated
- Mifepristone + Prednisone Contraindicated
- Prednisone + Radium-223 dichloride Contraindicated
- Prednisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Prednisone Major
Frequently asked questions
Can I take Nirmatrelvir / ritonavir with Prednisone?
MediHelp rates the interaction as moderate. Nirmatrelvir / ritonavir and Prednisone 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 strongly inhibits CYP3A4 and can raise systemic corticosteroid exposure. Prednisolone is affected less than other steroids, but prolonged coadministration raises the risk of Cushing syndrome and adrenal suppression.
How serious is the interaction between Nirmatrelvir / ritonavir and Prednisone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: For a short course, continue prednisone with monitoring for hyperglycemia and steroid adverse effects. For long-term steroid use, consider a lower dose or an alternative steroid.
What other medicines interact with Prednisone?
MediHelp also lists interactions of Prednisone with, for example, Bcg vaccine live, Measles vaccine, Mifepristone. The full list is on the Prednisone page.
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