ART DDIs Flashcards
Simvastatin or lovastatin
PIs contraindicated
Pravastatin
Avoid DRV/r
Atorvastatin
Rosuvastatin
Start with lowest possible statin dose
Benzodiazepines
PIs increase concentration
Bupropion
Sertraline
PIs and EFV decrease concentration
Cobi increases concentrations
PPIs
Contraindicated with ATV and RPV
H2 receptor antagonists
Administer ATV or RPV >10 h after dose
Phenytoin
PIs reduce levels
Use different AED
Carbamazepine
Pis increase carb levels and carb decreases pis
Phenobarbital
Really decreases pi levels
Lamotrigine
Pi reduce levels (up titrate)
Itraconazde
PIs or cobi increase itra or PI levels
Monitor itraconarole laurel
Posaconazole
Increases ATV levels - monitor for ade
Voriconazole
Reduced by RTV
Contraindicated with EFV
Isavuconazole
??? Interactions with PIs and NNRTIs
Inhaled, intranasal and intraarticular steroids
Contraindicated with boosters (ritonavir,cobi)
Rifampin or rifapentine
Contraindicated with: TAF PIs ETG/c MVC NNRTIs (EXCEPT EFV, but monitor VL closely)
Twice daily dosing:
DTG
RAL
Rifabutin
Contraindicated:
TAF
ETG/c
Decrease rifabutin dose if PIs
Increase rifabutin dose if NNRTI
No change to DTG, RAL
Estrogens
Avoid Boosted PIs (except ATV/r if > 35 ug ethinyl estradiol
Methadone
PIs decrease concentration
St John’s wort
Decreases PIs - contraindicated
Polyvalent cations
Must give 2 h before or 6 h after INSTIs
PDE5 inhibitors
Levels increased by PIs, start at low dose
Atazanavir
Needs to be given 2 hours before or 1 hour after antacids or buffered meds
Bictegravir
Needs to be given 2 hours before or 6 hours after aluminum or magnesium containing antacid (or calcium containing antacid if fasting - can be taken together wit food)
