Nirmatrelvir and ritonavir and Silodosin interaction

Nirmatrelvir and ritonavir and Silodosin: 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 Nirmatrelvir and ritonavir (Paxlovid) label · effective 2026-02-19

Major

…colchicine (in patients with renal and/or hepatic impairment [see Table 2 , Drug Interactions (7.3)] ) • Antipsychotics: lurasidone, pimozide • Benign prostatic hyperplasia agents: silodosin • Cardiovascular agents: eplerenone, ivabradine • Ergot derivatives: dihydroergotamine, ergotamine, methylergonovine • HMG-CoA reductase inhibitors: lovastatin, simvastatin…

Contraindicationsnames SilodosinView label on DailyMed
Major

Benign prostatic hyperplasia agents silodosin ↑ silodosin Co-administration contraindicated due to potential for postural hypotension [see Contraindications (4) ] .

Drug interactionsnames SilodosinView label on DailyMed

From the Silodosin label · effective 2026-03-16

Major

Severe renal impairment (CCr < 30 mL/min) Severe hepatic impairment (Child-Pugh score ≥ 10) Concomitant administration with strong Cytochrome P450 3A4 (CYP3A4) inhibitors (e.g., ketoconazole, clarithromycin, itraconazole, ritonavir) [see DRUG INTERACTIONS (7.1) ] Patients with a history of hypersensitivity to silodosin or any of the ingredients in silodosin capsules…

Contraindicationsby drug classView label on DailyMed
Major

Concomitant administration with strong Cytochrome P450 3A4 (CYP3A4) inhibitors (e.g., ketoconazole, clarithromycin, itraconazole, ritonavir).

Contraindicationsby drug classView label on DailyMed
Major

Concomitant use of ketoconazole or other strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin, ritonavir) is therefore contraindicated [see DRUG INTERACTIONS (7.1) ].

Warnings and precautionsby drug classView label on DailyMed
Major

Concomitant administration of strong CYP3A4 inhibitors and silodosin capsules is contraindicated [see CONTRAINDICATIONS (4) , WARNINGS AND PRECAUTIONS (5.4) and CLINICAL PHARMACOLOGY (12.3) ].

Drug interactionsby drug classView label on DailyMed
Moderate

Pharmacokinetic Drug-Drug Interactions In a drug interaction study, co‑administration of a single 8 mg dose of silodosin capsules with 400 mg ketoconazole, a strong CYP3A4 inhibitor, caused a 3.8‑fold increase in maximum plasma silodosin concentrations and 3.2‑fold increase in silodosin exposure (i.e., AUC).

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.