Dabigatran/Nirmatrelvir-Ritonavir Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process dabigatran properly.

What might happen:

Your blood levels of dabigatran may increase. This may cause serious bleeding.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to change your blood thinner. Let your healthcare professional know if the side effects of your medicine increase or if you have any bleeding from the eyes, gums or nose; unusual bruising; dark stools; red or dark brown urine; and/or abdominal pain or swelling.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop or change the dosage of any medication before checking with them first.

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  • 2.Pradax (dabigatran etexilate mesilate) Canadian prescribing information. Boehringer Ingelheim March, 23 2020.
  • 3.Pradaxa (dabigatran etexilate mesilate) UK summary of product characteristics. Boehringer Ingelheim Limited January 10, 2020.
  • 4.Anonymous. FDA Dabigatran background package for Cardio-Renal Advisory Committee. available at http://wayback.archive-it.org/7993/20170405212218/https://www.fda.gov/down loads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/Cardiovascularan dRenalDrugsAdvisoryCommittee/UCM247244.pdf September 20, 2010.
  • 5.Paxlovid (nirmatrelvir tablets and ritonavir tablets) US prescribing information. Pfizer Inc. May, 2023.
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  • 7.Vosevi (sofosbuvir/velpatasvir/voxilaprevir) US prescribing information. Gilead Sciences, Inc. September, 2019.
  • 8.Mavyret (glecaprevir and pibrentasvir) US prescribing information. AbbVie Inc. October, 2023.
  • 9.Pham P, Schmidt S, Lesko L, Lip GYH, Brown JD. Association of Oral Anticoagulants and Verapamil or Diltiazem With Adverse Bleeding Events in Patients With Nonvalvular Atrial Fibrillation and Normal Kidney Function. JAMA Netw Open;3(4)(2574-3805 (Electronic). 2574-3805 (Linking)):.
  • 10.Wiggins BS, Dixon DL, Neyens RR, Page RL 2nd, Gluckman TJ. Select Drug-Drug Interactions With Direct Oral Anticoagulants: JACC Review Topic of the Week..
  • 11.Cox DS, Rehman M, Khan T, Ginman K, Salageanu J, LaBadie RR, Wan K, Damle B. Effects of Nirmatrelvir/Ritonavir on Midazolam and Dabigatran Pharmacokinetics in Healthy Participants. Br J Clin Pharmacol 2023 Jun 24.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.