Drug Interactions and Pharmacokinetics Flashcards
Which drugs interact with acid reducing agents such as omeprazole or ranitidine
Atazanavir bioavailability is decreased by 62% when administered with these agents
Rilpiverine plasma concentrations are reduced when coadministered
Which ARVs cannot be used with polyvalent cations such as iron, magnesium, calcium and aluminium and antacids
Integrase inhibitors
When do you use TAF 10mg
In combinations with cobi or ritonavir as they inhibit intestinal P-gp
CYP inducers
CRAP GPS
Carbamazepine
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas
CYP inhibitors
ODEVICES
Omeprazole
Disulfuram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Cimetidine
Ethanol
Sulphonamides
Which booster both can inhibit and induce
Ritonavir
Maximal induction affect and resolution
10 days
Resolution depends on half life of inducer
Example Rifampicin and Midazolam
Inhibitors onset and resolution
Rapid for both after starting and. Stopping drug example is midazolam and ritonavir
What affect does administering DTG and metformin have
Increased systemic concentrations of metformin
Which contraception can be used with efavirenz
Levonorgestrel IUD and Depo
All the rest significantly reduce EFV exposure
Which ARVs need to be taken with food
Atazanavir/r/c
Darunavir/r/c
High dose lopinavir/r 800/100
Etravirine
Rilpivirine
Elvitegravir fixed dose combination
TDF-ideally
Which ARV should be taken on an empty stomach
Efavirenz
ARVs and drugs for gender affirmation
Ethinylestradiol only one not recommended due to thrombosis risk rest can be dose adjusted or monitored
Flucloxacillin ARV interactions
At high doses it is a liver enzyme induced
Use with caution with
Boosted ARVs
Bictegravir
Doravirine
Maraviroc
Rilpiverine
Avoid with
Cabotegravir/rilpiverine
Lenacapavir
Do not coadminister boosted PIs with the following drugs
Amiodarone
Rifampicin
Rifapentine
Apixaban
Clopidogrel
Rivaroxaban
Ticagrelor
Terfenidine
Oral midazolam
Domperidone
Eplerenone
Ivabradine
Lercanidipine
Sildenafil
St John’s wort
Red yeast rice
Budesonide
Fluticasone
Do not coadminister NNRTIs with the following
Rifampicin/rifapentin (except dapivirine)
Carbamazepine
Phenytoin
St John’s wort
Do not coadminister efavirenz with the following drugs
Isavuconazole
Ketoconazole
Midazolam
All contraceptives and HRT except levoIUD
Do not administer Rilpiverine with the following drugs
Rifampicin/ Rifapentine
Carbamazepine
Phenytoin
Omeprazole
Pantoprazole
Dexamethasone >16mg
Do not administer TAF with the following
Carbamazapine
Phenytoin
St John’s wort
Do not use elvitegravir/C with the following medications
Amiodarone
Dronedarone
Rifampicin
Rifapentin
Apixaban
Clopidogrel
Rivaroxaban
Ticagrelor
Carbamazepine
Phenytoin
Isavuconazole
Midazolam
Simvastatin
Budesonide
Fluticasone
Sildenafil
Ivabradine
Eplerenone
Domperidone
Do not administer Bictegravir with
Rifampicin
Rifapentin
Rifabutin
Carbamazapine
Phenytoin
ARVs associated with dyslipidaemia
Boosted PIs
Elvitagravir boosted
Efavirenz
