Drug interactions
Oxycodone + Ritonavir
Severity: Major
Oxycodone 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 strongly inhibits CYP3A4 and CYP2D6 and can substantially increase oxycodone exposure. Serious respiratory depression and prolonged sedation have been reported with this combination.
What this interaction means in plain words
Oxycodone 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.
Oxycodone belongs to Musculoskeletal; Ritonavir belongs to Anti Virals.
Why it happens
Potent CYP3A4 inhibition reduces oxycodone clearance, outweighing reduced 2D6-mediated oxymorphone formation.
What to do
Reduce the oxycodone dose and titrate carefully with close monitoring for respiratory depression. Consider an opioid less dependent on CYP3A4 when possible.
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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate Contraindicated
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 Oxycodone with Ritonavir?
MediHelp rates the interaction as major. Oxycodone 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 strongly inhibits CYP3A4 and CYP2D6 and can substantially increase oxycodone exposure. Serious respiratory depression and prolonged sedation have been reported with this combination.
How serious is the interaction between Oxycodone 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: Reduce the oxycodone dose and titrate carefully with close monitoring for respiratory depression. Consider an opioid less dependent on CYP3A4 when possible.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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