Drug interactions
Ritonavir + Sacubitril-valsartan
Severity: Moderate
Ritonavir and Sacubitril-valsartan: 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 can inhibit hepatic transporters involved in valsartan disposition, such as OATP1B1 and MRP2, which may raise valsartan exposure. This may increase hypotension, hyperkalemia or renal effects.
What this interaction means in plain words
Ritonavir and Sacubitril-valsartan 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 belongs to Anti Virals; Sacubitril-valsartan belongs to Cardiovascular.
Why it happens
Inhibition of hepatic uptake and efflux transporters (OATP1B1, MRP2) reduces hepatic clearance of valsartan.
What to do
Monitor blood pressure, serum potassium and renal function after starting or stopping ritonavir, and reduce the sacubitril-valsartan dose if symptomatic hypotension occurs.
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 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
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 Ritonavir with Sacubitril-valsartan?
MediHelp rates the interaction as moderate. Ritonavir and Sacubitril-valsartan 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 can inhibit hepatic transporters involved in valsartan disposition, such as OATP1B1 and MRP2, which may raise valsartan exposure. This may increase hypotension, hyperkalemia or renal effects.
How serious is the interaction between Ritonavir and Sacubitril-valsartan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, serum potassium and renal function after starting or stopping ritonavir, and reduce the sacubitril-valsartan dose if symptomatic hypotension occurs.
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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