ARV Drug interactions

  1. Antacids and PPI
    • Decreases effect of Atazanavir
    • H2 blocker: separate use by 10 hours
    • Antacids: separate use by 2 hours
  2. Empty stomach
    • Didanosine
    • Indinavir
  3. Take with food
    PIs except Indinavir
  4. Avoid high fat meal
    • Efavirenz
    • Amprenavir
  5. Take with fatty meals
    • Tenofovir
    • Nelfinavir
  6. No food effect
    NRTI
  7. Darunavir
    Increased AUC with food and ritonavir by 30%
  8. Etravirine
    Fasting decreased absorption by 50%
  9. Maraviroc
    AUC decreased 50% with food
  10. Raltegravir
    No effect by food
  11. Lipid lowering agents
    • Use pravastatin or rosuvastatin
    • Atorvastatin with low dose and careful monitoring
  12. Anti-TB
    Rifampin
  13. Midazolam, triazolam
    Use with caution and low dose
  14. SSRI
    • Fluoxetine can cause serotonin syndrome
    • Use citalopram or escitalopram
  15. Trazadone
    Use lowest dose and monitor CNS and CV effects
  16. Neurlopetics
    • Variable effects
    • Titrate to response
  17. Others
    • Ergot alkaloids
    • Antihistamines - astimazole
  18. Carbamazepine
    Monitor levels
  19. Lamotrigine
    Titrate to effect due to decrease levels
  20. Phenytoin
    • Dual interaction
    • Use alternative
  21. Valproic acid
    • Dual interaction
    • Monitor levels
  22. Oral contraceptive
    Ethinyl estradiol and norethindrone decrease AUC
  23. Methadone
    Increase levels to avoid withdrawal
  24. Erectile dysfunction agents
    Cut dose by 50% with PIs
  25. St. John's Wort
    Decreased Indinavir
  26. Fluticasone
    Combination with Ritonavir increases concentration of fluticasone
Author
pdnguyen
ID
80843
Card Set
ARV Drug interactions
Description
ARV Drug interactions
Updated