Drug interactions
Ritonavir + Trimipramine
Severity: Major
Ritonavir and Trimipramine: 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 inhibits hepatic enzymes that metabolize tricyclic antidepressants, raising trimipramine concentrations. This may cause anticholinergic effects, sedation, hypotension and cardiac conduction or QT effects.
What this interaction means in plain words
Ritonavir and Trimipramine 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 belongs to Anti Virals; Trimipramine belongs to Central Nervous System.
Why it happens
Ritonavir inhibits CYP3A4 and CYP2D6, reducing trimipramine metabolism.
What to do
Start trimipramine at a low dose and titrate to clinical response, ideally with plasma level monitoring. Obtain an ECG and watch for toxicity.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ritonavir and Trimipramine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine 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 Trimipramine?
MediHelp rates the interaction as major. Ritonavir and Trimipramine 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 inhibits hepatic enzymes that metabolize tricyclic antidepressants, raising trimipramine concentrations. This may cause anticholinergic effects, sedation, hypotension and cardiac conduction or QT effects.
How serious is the interaction between Ritonavir and Trimipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start trimipramine at a low dose and titrate to clinical response, ideally with plasma level monitoring. Obtain an ECG and watch for toxicity.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
