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, Fall 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, go to the database, click on a specific drug name, and search for the interacting agent.

New ARV Interactions (August-October 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
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