Drugs Flashcards
PPI
Contraindicated with atazanavir and rilpiverine as both require low gastric pH
Antacids and H2 blockers ok but take at different time - less long lasting effect
Antacids
Need to be timed away from integrases due to chelation of II
Dabigatran
Coadministration with ritonivir and cobicistat increases dabigatran exposure and therefore increases bleeding risk
can give with ritonivir with close monitoring
Cannot give with cobicistat
Metformim
Increased exposure with DTG
Risk is lactic acidosis
Close monitor and consider adjusting dose with DTG. Close monitoring with BIC only if renal impairment.
IM carbotegravir/rilpivirine
Exposure reduced by strong enzyme inducers eg rifampicin
Avoids other DDI eg. Antacids
Corticosteroids
Avoid with boosters
Risk of Cushing syndrome increased even if not taking steroid orally
Beclometasone safest
Clopidogrel
Not with boosters - 44% HIV patients not achieving platelet inhibition
Prasugel is ok
If must have clopidogrel change ARVs
Injectable?
Carbotegravir with rilpivirine Aqueous particle suspension Monthly use Cabenuva ATLAS and FLAIR trial
Micro needle patch
7 days exposure achieved from 1 patch with rilpivirine
Apixaban
Induced by ETR
EDOXABAN SAFER
DOACs
Not with PIs - increase exposure
Not with NNRTI - decrease exposure (Doravirine safe)
INSTI safe