Updates to the Database of ARV Drug Interactions

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Updates to the Database of ARV Drug Interactions

HIV Meds Quarterly Research Brief, Spring 2009

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, click on a specific drug name in the table below and search for the interacting agent.

New ARV Interactions (January-April 2009)

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
Raltegravir	Atazanavir	Possibly ↑ raltegravir effects		Dosage adjustment not established
Nevirapine	Fluconazole	Possibly ↑ increased nevirapine effects	Inhibition of CYP450 3A4 by fluconazole	No dosage adjustment necessary
Atazanavir	Simvastatin	↑ simvastatin effects (eg, myopathy, rhabdomyolysis)	Inhibition of CYP450 3A4 by atazanavir	Do not coadminister *Alternative agents:* Atorvastatin (low dose); pravastatin
Efavirenz	Posaconazole	↓ posaconazole effects	Induction of UDP-G by efavirenz	Avoid coadministration if possible
Ritonavir	Posaconazole	↑ ritonavir effects	Inhibition of CYP450 3A4 by posaconazole	Monitor closely for adverse effects during coadministration
Atazanavir	Posaconazole	↑ atazanavir effects	Inhibition of CYP450 3A4 by posaconazole	Monitor closely for adverse effects during coadministration
Atazanavir/ritonavir	Posaconazole	↑ atazanavir effects	Inhibition of CYP450 3A4 by posaconazole	Monitor closely for adverse effects during coadministration
Lopinavir/ritonavir	Prednisone	Possibly ↑ prednisolone effects		No dosage adjustment necessary
Efavirenz	Prednisone	Possibly ↑ prednisolone effects		No dosage adjustment necessary