Drug interactions
Ritonavir + Venetoclax
Severity: Major
Ritonavir and Venetoclax: 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 CYP3A4 and P-gp and substantially increases venetoclax concentrations. This raises the risk of tumor lysis syndrome and neutropenia, especially during dose ramp-up.
What this interaction means in plain words
Ritonavir and Venetoclax 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; Venetoclax belongs to Miscellaneous.
Why it happens
Strong CYP3A4 and P-gp inhibition by ritonavir reduces venetoclax metabolism and efflux.
What to do
Avoid the combination, particularly during initiation and ramp-up. If unavoidable, reduce venetoclax dose substantially per labeling and monitor closely for tumor lysis and neutropenia.
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 Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Other interactions of Venetoclax
- Clarithromycin + Venetoclax Contraindicated
- Itraconazole + Venetoclax Contraindicated
- Ketoconazole + Venetoclax Contraindicated
- Posaconazole + Venetoclax Contraindicated
- Venetoclax + Voriconazole Contraindicated
- Amiodarone + Venetoclax Major
Frequently asked questions
Can I take Ritonavir with Venetoclax?
MediHelp rates the interaction as major. Ritonavir and Venetoclax 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 CYP3A4 and P-gp and substantially increases venetoclax concentrations. This raises the risk of tumor lysis syndrome and neutropenia, especially during dose ramp-up.
How serious is the interaction between Ritonavir and Venetoclax?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination, particularly during initiation and ramp-up. If unavoidable, reduce venetoclax dose substantially per labeling and monitor closely for tumor lysis and neutropenia.
What other medicines interact with Ritonavir?
MediHelp also lists interactions of Ritonavir with, for example, Alfuzosin, Amiodarone, Avanafil. The full list is on the Ritonavir page.
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