Drug interactions
Nirmatrelvir / ritonavir + Propafenone
Severity: Contraindicated
Nirmatrelvir / ritonavir and Propafenone: contraindicated 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 CYP2D6, the main pathways clearing propafenone. Propafenone levels can rise considerably, risking ventricular arrhythmia, conduction block and other serious toxicity.
What this interaction means in plain words
Nirmatrelvir / ritonavir and Propafenone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Ritonavir inhibits CYP3A4 and CYP2D6, decreasing propafenone clearance.
What to do
Avoid the combination. Use an alternative COVID-19 treatment, or seek specialist advice about interrupting propafenone.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Nirmatrelvir / ritonavir and Propafenone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
- Propafenone + Ritonavir Contraindicated
Frequently asked questions
Can I take Nirmatrelvir / ritonavir with Propafenone?
MediHelp rates the interaction as contraindicated. Nirmatrelvir / ritonavir and Propafenone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ritonavir strongly inhibits CYP3A4 and CYP2D6, the main pathways clearing propafenone. Propafenone levels can rise considerably, risking ventricular arrhythmia, conduction block and other serious toxicity.
How serious is the interaction between Nirmatrelvir / ritonavir and Propafenone?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination. Use an alternative COVID-19 treatment, or seek specialist advice about interrupting propafenone.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
