التداخل بين ريتونافير وسيلدينافيل

…lovastatin, simvastatin ○ Microsomal triglyceride transfer protein (MTTP) Inhibitor: lomitapide ○ Non-opioid Analgesic (selective blocker of Na v 1.8 sodium channels): suzetrigine ○ PDE5 Inhibitor: sildenafil (Revatio ® ) when used for the treatment of pulmonary arterial hypertension ○ Sedative/Hypnotics: triazolam, orally administered midazolam • NORVIR is contraindicated…

Use of PDE5 inhibitors for pulmonary arterial hypertension (PAH): Sildenafil (Revatio ® ) is contraindicated [see Contraindications ( 4 ) ] .

Particular caution should be used when prescribing sildenafil, tadalafil or vardenafil in patients receiving ritonavir.

PDE5 Inhibitors: avanafil sildenafil, tadalafil, vardenafil ↑ avanafil ↑ sildenafil ↑ tadalafil ↑ vardenafil Sildenafil when used for the treatment of pulmonary arterial hypertension (Revatio ® ) is contraindicated due to the potential for sildenafil-associated adverse events, including visual abnormalities, hypotension, prolonged erection, and syncope [see Contraindications…

Coadministration of ritonavir with these drugs may result in an increase in PDE5 inhibitor associated adverse events, including hypotension, syncope, visual changes, and prolonged erection.

In patients taking strong CYP inhibitors such as ritonavir, sildenafil exposure is increased.

To decrease the chance of adverse reactions in patients taking ritonavir, the maximum recommended dosage and dosing frequency of SILDENAFIL ORAL FILM is 25 mg once in a 48-hour period [see Dosage and Administration ( 2.2 ), Drug Interactions ( 7.4 ), and Clinical Pharmacology ( 12.3 ) ].

Ritonavir: Do not exceed a maximum single dose of 25 mg in a 48- hour period.

Adverse Reactions with the Concomitant Use of Ritonavir The concomitant administration of the protease inhibitor ritonavir substantially increases serum concentrations of sildenafil (11-fold increase in AUC).

CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole, erythromycin) increase SILDENAFIL ORAL FILM exposure.