Ritonavir

Codeine

Dosage adjustment may be necessary.

No pharmaceutical opinion available for this interaction.

Mechanism

Ritonavir may inhibit the metabolism (CYP2D6) and decrease the conversion into morphine, active metabolite of Codeine.

Ritonavir

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Codeine

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

Monitor for clinical efficacy.

Dosage adjustment may be required.

Alternative solution(s)

Hydromorphone ou morphine.

Monitor

Signs and symptoms of opioid withdrawal : craving for opioids, irritability, myalgias, muscle spasms, flushing, abdominal pain, nausea, vomiting, diarrhea, restlessness, diaphoresis, lacrimation, rhinorrhea, mydriasis, yawning, piloerection (goose flesh), tachycardia, tremulousness.

Tests

Pharmacokinetic parameters

Comment

Reference
  • 2572
    Ritonavir (Norvir), Corporation AbbVie, Quebec, Canada, 25 septembre 2018.
  • 2616
    Susce MT, Murray-Carmichael E, de Leon J. Response to hydrocodone, codeine and oxycodone in a CYP2D6 poor metabolizer. Prog Neuropsychopharmacol Biol Psychiatry. 2006. September 30; 30(7): 1356-1358.