Ritonavir Almotriptan

ALMOTRIPTAN, ELETRIPTAN PROTEASE INHIBITORS -INDINAVIR, NELFINAVIR, RITONAVIR Possibly t adverse effects when almotriptan or eletriptan is coadministered with indinavir, ritonavir (with or without lopinavir), or nelfinavir Inhibition of CYP3A4- and possibly CYP2D6-mediated metabolism of eletriptan, and CYP3A4-mediated metabolism of almotriptan Avoid co-administration... 

Clinically important, potentially hazardous interactions with almotriptan, amprenavir, clarithromycin, darunavir, delavirdine, efavirenz, erythromycin, fosamprenavir, indinavir, naratriptan, nelfinavir, nilotinib, ritonavir, rizatriptan, saquinavir, sibutramine, sumatriptan, telithromycin, tipranavir, troleandomycin, zolmitriptan... 

The manufacturers state that the concurrent use of eletriptan and ritonavir, indinavir, or nelfinavir should be avoided, because these protease inhibitors are potent inhibitors of the cytochrome P450 isoenzyme CYP3A4, an enzyme involved in the metabolism of eletriptan. Concurrent use would therefore be expected to markedly increase levels of eletriptan. In addition, the US manufacturers recommend that eletriptan should not be given within 72 hours of ritonavir and nelfinavir. This predicted interaction is based on the known interaction with eiythromycin , (p.604) and ketoconazole , (p.601). Similar predictions are made by the manufacturers of almotriptan, and they advise caution with the use of ritonavir. ... 

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