Drug interactions
Ritonavir + Sirolimus
Severity: Contraindicated
Ritonavir and Sirolimus: 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 P-gp, which can greatly raise sirolimus concentrations and cause toxicity such as myelosuppression, hyperlipidemia, infections and impaired wound healing. Sirolimus labeling advises against use with strong CYP3A4 inhibitors.
What this interaction means in plain words
Ritonavir and Sirolimus 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 belongs to Anti Virals; Sirolimus belongs to Miscellaneous.
Why it happens
Ritonavir inhibits CYP3A4 and P-glycoprotein, reducing sirolimus metabolism and efflux.
What to do
Avoid concurrent use; choose an antiretroviral without boosting if possible. If unavoidable, reduce the sirolimus dose substantially and monitor troughs closely under specialist guidance.
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?
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Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus 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 Sirolimus?
MediHelp rates the interaction as contraindicated. Ritonavir and Sirolimus 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 P-gp, which can greatly raise sirolimus concentrations and cause toxicity such as myelosuppression, hyperlipidemia, infections and impaired wound healing. Sirolimus labeling advises against use with strong CYP3A4 inhibitors.
How serious is the interaction between Ritonavir and Sirolimus?
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 concurrent use; choose an antiretroviral without boosting if possible. If unavoidable, reduce the sirolimus dose substantially and monitor troughs closely under specialist guidance.
What other medicines interact with Sirolimus?
MediHelp also lists interactions of Sirolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Sirolimus page.
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