for Health Care Providers
Updates to the Database of ARV Drug Interactions
The following table summarizes recent additions to the HIV InSite Database of Antiretroviral Drug Interactions
. For a full description of the updates, including references to the studies from which the data were derived, go to the database, click on a specific drug name, and search for the interacting agent.
| Drug One | Drug Two | Clinical Effects | Mechanisms | Management |
|---|---|---|---|---|
| Source: McNicholl I. HIV InSite Database of Antiretroviral Drug Interactions. University of California San Francisco: Center for HIV Information; 2009 | ||||
| Atazanavir | Fosamprenavir | ↑ amprenavir effects; ↓ atazanavir effects | Possible induction of CYP450 3A4 by fosamprenavir | Do not coadminister |
| Didanosine | Buprenorphine | No dosage adjustment necessary | ||
| Etravirine | Fluconazole | ↑ etravirine effects | Inhibition of CYP450 3A4 by fluconazole | Dosage adjustment not established |
| Etravirine | Lopinavir/ritonavir | Potentially ↓ etravirine effects | Potential induction of CYP450 3A4, 2C9, and 2C19 by lopinavir/ritonavir | No dosage adjustment necessary |
| Etravirine | Raltegravir | No dosage adjustment necessary | ||
| Etravirine | Voriconazole | Possibly ↑ etravirine effects | Inhibition of CYP450 3A4 by voriconazole | No dosage adjustment necessary |
| Fosamprenavir (400 mg BID) | Raltegravir (1,400 mg BID) | Possible induction of p-gp | No dosage adjustment necessary | |
| Fosamprenavir (400 mg BID) | Raltegravir (700 mg fosamprenavir BID with 100 mg ritonavir BID) | Possible induction of p-gp | No dosage adjustment necessary | |
| Lamivudine | Buprenorphine | No dosage adjustment necessary | ||
| Raltegravir | Efavirenz | Induction of UGT1A1 by efavirenz | No dosage adjustment necessary | |
| Raltegravir | Lamotrigine | No dosage adjustment necessary | ||
| Raltegravir | Rifabutin | No dosage adjustment necessary | ||
| Raltegravir | Rifampin | Possibly ↓ raltegravir effects | Induction of UGT1A1 by rifampin | Do not coadminister Alternative agents: Rifabutin |
| Raltegravir | Ritonavir | Induction of UGT1A1 by ritonavir | No dosage adjustment necessary | |
| Raltegravir | Tipranavir | Induction of UGT1A1 by tipranavir/ritonavir | No dosage adjustment necessary | |
| Ritonavir (200 mg BID) | Alprazolam (1 mg x 1 dose) | ↑ alprazolam effects (eg, ↑ sedation, confusion, respiratory depression) | Inhibition of CYP450 3A4 by ritonavir | Avoid combination; consider alternative agents Alternative agents: Lorazepam |
| Ritonavir | Triazolam | ↑ triazolam effects (eg, ↑ sedation, confusion, respiratory depression) | Inhibition of CYP450 3A4 by ritonavir | Avoid combination; consider alternative agents Alternative agents: Lorazepam Oxazepam Temazepam Trazodone |
| Ritonavir | Zolpidem | ↑ zolpidem effects (eg, ↑ sedation, confusion) | Inhibition of CYP450 3A4 by ritonavir | No dosage adjustment necessary |
| Tenofovir | Buprenorphine | No dosage adjustment necessary | ||
| Tenofovir | Ethinyl estradiol/ norgestimate | No dosage adjustment necessary | ||
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