Ritonavir/Meperidine 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 your pain medicine properly.

What might happen:

If you take these medicines together for a long time, or if your dose of meperidine is increased, you may have toxic effects from meperidine, such as drowsiness, slurred speech, or seizures.

What you should do about this interaction:

Talk to your healthcare professionals (e.g. doctor or pharmacist) about taking these two medicines together. If you need to be taking an opioid pain medicine for a long time, or if your meperidine stops working as well and you need a larger dose, your doctor may want to change your pain medicine.Ask your doctor or pharmacist if you should have naloxone available to treat opioid overdose. Teach your family or household members about the signs of an opioid overdose and how to treat it. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, give them naloxone if available, then call 911. If the person is awake and has no symptoms, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow/shallow breathing, slow heartbeat, coma.Your healthcare professionals may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
  • 2.Norvir (ritonavir) US prescribing information. Abbott Laboratories December, 2019.
  • 3.Piscitelli SC, Kress DR, Bertz RJ, Pau A, Davey R. The effect of ritonavir on the pharmacokinetics of meperidine and normeperidine. Pharmacotherapy 2000 May;20(5):549-53.
  • 4.Demerol (meperidine hydrochloride) US prescribing information. Validus Pharmaceuticals LLC. December, 2023.
  • 5.USFood and Drug Administration. FDA Drug Safety Communication: FDA updates prescribing information for all opioid pain medicines to provide additional guidance for safe use. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-prescri bing-information-all-opioid-pain-medicines-provide-additional-guidance-saf e-use?utm_medium=email&utm_source=govdelivery April 13, 2023.
  • 6.USFood and Drug Administration. FDA Drug Safety Communication: FDA recommends health care professionals discuss naloxone with all patients when prescribing opioid pain relievers or medicines to treat opioid use disorder. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-recommends-heal th-care-professionals-discuss-naloxone-all-patients-when-prescribing-opioi d-pain July 23, 2020.

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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.