Drug interactions
Nirmatrelvir / ritonavir + Sacubitril-valsartan
Severity: Minor
Nirmatrelvir / ritonavir and Sacubitril-valsartan: minor 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 inhibit hepatic uptake transporters such as OATP1B1 that handle valsartan and sacubitril's active metabolite, which could modestly raise exposure. Because nirmatrelvir/ritonavir is given for only a short course, the effect is generally of limited clinical importance.
What this interaction means in plain words
Nirmatrelvir / ritonavir and Sacubitril-valsartan have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Inhibition of hepatic uptake transporters (OATP1B1) by ritonavir reduces hepatic clearance of valsartan.
What to do
No dose change is usually needed; monitor blood pressure and for hypotension or hyperkalemia during the course.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Sacubitril-valsartan
- Aliskiren + Sacubitril-valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Lisinopril + Sacubitril-valsartan Contraindicated
Frequently asked questions
Can I take Nirmatrelvir / ritonavir with Sacubitril-valsartan?
MediHelp rates the interaction as minor. Nirmatrelvir / ritonavir and Sacubitril-valsartan have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Ritonavir may inhibit hepatic uptake transporters such as OATP1B1 that handle valsartan and sacubitril's active metabolite, which could modestly raise exposure. Because nirmatrelvir/ritonavir is given for only a short course, the effect is generally of limited clinical importance.
How serious is the interaction between Nirmatrelvir / ritonavir and Sacubitril-valsartan?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No dose change is usually needed; monitor blood pressure and for hypotension or hyperkalemia during the course.
What other medicines interact with Sacubitril-valsartan?
MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.
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