Drug interactions
Nirmatrelvir / ritonavir + Vardenafil
Severity: Major
Nirmatrelvir / ritonavir and Vardenafil: 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 in this combination strongly inhibits CYP3A4 and markedly increases vardenafil exposure. Severe hypotension, syncope, priapism and QT prolongation may occur.
What this interaction means in plain words
Nirmatrelvir / ritonavir and Vardenafil 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.
Why it happens
Strong CYP3A4 inhibition by ritonavir reduces vardenafil clearance.
What to do
Withhold vardenafil during treatment where feasible; if used, do not exceed 2.5 mg in 72 hours and monitor blood pressure.
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 Vardenafil
- Amyl nitrite + Vardenafil Contraindicated
- Glyceryl trinitrate pr + Vardenafil Contraindicated
- Isosorbide dinitrate + Vardenafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Nicorandil + Vardenafil Contraindicated
- Nitroglycerin po + Vardenafil Contraindicated
Frequently asked questions
Can I take Nirmatrelvir / ritonavir with Vardenafil?
MediHelp rates the interaction as major. Nirmatrelvir / ritonavir and Vardenafil 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 in this combination strongly inhibits CYP3A4 and markedly increases vardenafil exposure. Severe hypotension, syncope, priapism and QT prolongation may occur.
How serious is the interaction between Nirmatrelvir / ritonavir and Vardenafil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Withhold vardenafil during treatment where feasible; if used, do not exceed 2.5 mg in 72 hours and monitor blood pressure.
What other medicines interact with Vardenafil?
MediHelp also lists interactions of Vardenafil with, for example, Amyl nitrite, Glyceryl trinitrate pr, Isosorbide dinitrate. The full list is on the Vardenafil page.
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