Efavirenz and Ritonavir interaction

Efavirenz and Ritonavir: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Efavirenz label · effective 2024-03-31

Major

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz.

Drug interactionsby drug classView label on DailyMed
Moderate

No change in the ritonavir dose is required when efavirenz is administered with fosamprenavir plus ritonavir twice daily.

Drug interactionsnames RitonavirView label on DailyMed
Moderate

The dose of lopinavir/ritonavir must be increased when coadministered with efavirenz.

Drug interactionsnames RitonavirView label on DailyMed
Moderate

See the lopinavir/ritonavir prescribing information for dose adjustments of lopinavir/ritonavir when coadministered with efavirenz in adult and pediatric patients.

Drug interactionsnames RitonavirView label on DailyMed
Moderate

…Alteration in Dose or Regimen May Be Recommended Based on Drug Interaction Studies or Predicted Interaction Concomitant Drug Class: Drug Name Effect Clinical Comment HIV antiviral agents Protease inhibitor: Fosamprenavir Calcium ↓ amprenavir Fosamprenavir (unboosted): Appropriate doses of the combinations with respect to safety and efficacy have not been established.

Drug interactionsby drug classView label on DailyMed

From the Ritonavir (Norvir) label · effective 2026-07-23

Moderate

Hepatotoxicity Hepatic transaminase elevations exceeding 5 times the upper limit of normal, clinical hepatitis, and jaundice have occurred in patients receiving NORVIR alone or in combination with other antiretroviral drugs (see Table 2).

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.