Pharmacokinetic interaction between nirmatrelvir/ritonavir and nifedipine: A case report - PubMed
6 hours ago
- #drug-interaction
- #COVID-19
- #pharmacokinetics
- Nirmatrelvir/ritonavir (NMV-r) is used to treat COVID-19 and contains ritonavir, which can increase exposure to drugs metabolized by CYP3A4, like nifedipine.
- A case study of a 68-year-old woman on nifedipine CR and telmisartan showed a significant increase in nifedipine plasma concentrations (4-fold at 24h, 7-fold at 96h) after a 50% dose reduction upon NMV-r initiation.
- Ritonavir increased the AUC of nifedipine by approximately 14-fold, leading to hypotension, which required discontinuation of telmisartan.
- The study suggests temporary discontinuation of nifedipine or prompt withdrawal in case of symptomatic hypotension as a safer strategy for patients on ritonavir-containing therapy.