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COPD: Potential ARV Interactions

for Health Care Providers

Table 3: Potential ARV Interactions

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ARVs and inhaled corticosteroids


  • PIs: Caution: ↑ serum fluticasone levels; can cause systemic corticosteroid side effects, including Cushing syndrome
    • Avoid (or limit) use with RTV, particularly in the LPV/r, ATV/r, and DRV/r combinations
    • Even boosting doses (eg, 100 mg BID) of RTV may ↑ fluticasone Cmax by 2,500%
    • ATV: can ↑ fluticasone levels - use with caution
  • It is unclear whether significant interactions occur between other inhaled steroids and PIs
  • NRTIs, NNRTIs: no significant interactions expected

ARVs and theophylline

  • RTV: ↓ theophylline AUC
  • IDV: small ↑ in theophylline AUC
  • Monitor and adjust theophylline dosage as needed

From Chronic Obstructive Pulmonary Disease
Primary Care of Veterans with HIV
Office of Clinical Public Health Programs
Veterans Health Administration, 2009