Drug interactions
Ritonavir + Tolvaptan
Severity: Contraindicated
Ritonavir and Tolvaptan: 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 is a potent CYP3A4 inhibitor that is expected to substantially increase tolvaptan exposure. This may cause excessive aquaresis, dehydration, and too rapid correction of serum sodium.
What this interaction means in plain words
Ritonavir and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Potent inhibition of CYP3A4 reduces tolvaptan metabolism.
What to do
Do not use together; use an alternative agent or hold tolvaptan during ritonavir therapy with serum sodium monitoring.
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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan 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 Tolvaptan?
MediHelp rates the interaction as contraindicated. Ritonavir and Tolvaptan 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 is a potent CYP3A4 inhibitor that is expected to substantially increase tolvaptan exposure. This may cause excessive aquaresis, dehydration, and too rapid correction of serum sodium.
How serious is the interaction between Ritonavir and Tolvaptan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; use an alternative agent or hold tolvaptan during ritonavir therapy with serum sodium monitoring.
What other medicines interact with Tolvaptan?
MediHelp also lists interactions of Tolvaptan with, for example, Atazanavir, Ceritinib, Cobicistat. The full list is on the Tolvaptan page.
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