Risperidone Ritonavir

Rilmenidine dihydrogen phosphate Riluzole tablets Risperidone Ritonavir capsules Rivastigmine caps Rocuromiem bromide injection Rofecoxib... 

Clinically important, potentially hazardous interactions with caffeine, carbamazepine, cocoa, fluoxetine, guarana, insulin glulisine, risperidone, ritonavir, selenium, uracil/tegafur... 

Lee SI, Klesmer J, Hirsch BE. Neuroleptic malignant syndrome associated with the use of risperidone, ritonavir and indinavir a case report. Psychosomatics (2000) 41, 453-4. 

Jover F, Cuadrado J-M, Andreu L, Merino J. Reversible coma caused by risperidone-ritonavir interaction. Clin Neuropharmacol (2002) 25, 251-3. 

Risperdal 60 Risperidone 60 Ritain 48 Ritonavir 60 Rizatriptan 60 Robaxin 48 Robitussin 39 Robitussin A-C 81 Robitussin-CF 81 Robitussin-DAC 81 Robitussin-PE 81 Rocaltrol 20 Rocephin 22 Rofecoxib 60 Rogaine 49 Romazicon 36 Ropinirde 60 Rosiditazone 60... 

Drugs that may interact with clozapine include caffeine, SSRIs, benzodiazepines, risperidone, CYP1A2 induces/inhibitors, CYP3A4 inhibitors, phenobarbital, and ritonavir. 

D6 Tricyclic antidepressants (TCAs), benztropine, perphenazine, clozapine, haloperidol, codeine/oxycodone, risperidone, class Ic antiarrhythmics, 3 blockers, trazodone, paroxetine, maprotiline, amoxapine, duloxetine, mirtazapine (partly), venlafaxine, bupropion Fluoxetine, paroxetine, duloxetine, hydroxybupropion, methadone, cimetidine, haloperidol, quinidine, ritonavir Phenobarbital, rifampin... 

A 34-year-old man with AIDS took risperidone 4 mg/ day for a Tourette-like tic disorder. Ritonavir and indinavir were added, and 1 week later he developed significantly impaired swallowing, speaking, and breathing, and worsening of his existing tremors. 

The authors hypothesized that inhibition of CYP2D6 and CYP3A4 by ritonavir and indinavir may have resulted in accumulation of the active moiety of risperidone. 

Kelly DV, Beique LC, Bowmer MI. Extrapyramidal symptoms with ritonavir/indinavir plus risperidone. Ann Pharmacother 2002 36(5) 827-30. 

ARIPIPRAZOLE, HALOPERIDOL, CLOZAPINE, PIMOZIDE, RISPERIDONE, SERTINDOLE PROTEASE INHIBITORS Possibly T levels of antipsychotic Inhibition of CYP3A4- and/or CYP2D6-mediated metabolism Avoid co-administration of clozapine with ritonavir, and pimozide or sertindole with protease inhibitors. Use other antipsychotics with caution as 1 dose may be required with risperidone, watch closely for extrapyramidal side-effects and neuroepileptic malignant syndrome... 

An interaction of risperidone with ritonavir and indinavir has been reported (160). 

The neuroleptic malignant syndrome, ataxia and severe lethai leading to a coma, and extrapyramidal adverse effects have been seen in patients given risperidone with indinavir and ritonavir. 

Indinavir inhibits the cytochrome P450 isoenzyme CYP3A4 and ritonavir inhibits CYP2D6 and CYP3A4, which are the main isoenzymes involved in the metabolism of risperidone. Therefore eoncurrent use would be expected to raise risperidone levels. The symptoms reported in the cases above may have all been due to increased risperidone levels. ... 

These appear to be the only reports of an interaction between risperidone and protease inhibitors, and their general significanee is unclear. Until more is known it would be prudent to monitor patients taking risperidone who are given these protease inhibitors, particularly ritonavir, for risperidone adverse effects. 

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