Drug Interactions

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  • Efavirenz, Dolutegravir, and Darunavir: Pharmacokinetics during Pregnancy

    Jennifer Cocohoba's picture

    Three studies presented at the 2016 Conference on Retroviruses and Opportunistic Infections (CROI) explored the pharmacokinetics of antiretrovirals administered during pregnancy. These studies support the use of standard-dose efavirenz, once-daily dolutegravir, and BID ritonavir-boosted...

  • START-ing TEMPRANO: Early Initiation of Antiretroviral Therapy for HIV

    Jennifer Cocohoba's picture

    The prevailing opinion among experts regarding the optimal CD4 T-cell count at which to start patients on antiretroviral therapy (ART) has shifted several times during the evolution of HIV treatment. These shifts reflect attempts to strike a balance between preventing HIV-associated illness and...

  • Adult and Adolescent Guidelines: Major Changes

    Susa Coffey's picture

    The U.S. Department of Health and Human Services has released new treatment guidelines for adults and adolescents, and these contain some important changes. Key among these is a major shakeup in the "Recommended Regimen Options" for initial therapy. 

    Efavirenz/TDF/FTC (Atripla) has...
  • Drug-Drug Interactions: Etravirine with Dolutegravir or Atazanavir

    Susa Coffey's picture

    New data show that etravirine (ETR) substantially lowers plasma concentrations of dolutegravir (DTG) (DTG Cmin decreased 88%, AUC decreased 71%). This effect is lessened by coadministration of ritonavir-boosted PIs: the combination of ETR + DTG + darunavir/...

  • HIV Meds Updates: Fast Takes - ATV & Rilpivirine / Rifabutin

    Susa Coffey's picture
    ATV pediatric powder formulation

    An oral powder formulation of atazanavir has been approved by the FDA for use in infants and children older than 3 months and weighing 10 to <25 kg. It must administered with ritonavir, and used in combination with other antiretrovirals. For infants, it may be...

  • Drug Interactions: Integrase Inhibitors and Cations

    Susa Coffey's picture

    Antacids, laxatives, mineral supplements, and other compounds that contain metal cations (eg, calcium, magnesium, aluminum, and iron) may decrease levels of integrase inhibitors if taken close in time to each other. Results of two studies help to assess the magnitude of this effect and assist in...

  • Clinically Significant Drug Interactions with Dolutegravir

    Ian R. McNicholl's picture

    Coauthor: Susa Coffey, MD; Medical Editor, AETC National Resource Center

    Dolutegravir, the newly approved integrase inhibitor, has a number of important drug interactions with other medications and nutritional products. Listed below are highlights of some of the...

  • Updates to the Database of ARV Drug Interactions

    Ian R. McNicholl's picture

    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...

  • Interactions with Hepatitis C Protease Inhibitors

    Susa Coffey's picture
    Rilpivirine and Boceprevir

    Boceprevir (BOC) is a hepatitis C virus (HCV) NS3/4A protease inhibitor used in combination with pegylated interferon + ribavirin for the treatment of HCV. As BOC is an inhibitor of hepatic cytochrome (CYP) 3A4, and many protease inhibitors and NNRTIs affect or are...

  • Pitavastatin and Darunavir/Ritonavir

    Ian R. McNicholl's picture

    Coauthor: Susa Coffey, MD; Medical Editor, AETC National Resource Center

    Treatment of dyslipidemia is often complicated by drug interactions between statins and antiretrovirals. Pitavastatin is one of the newer statins approved and is one of the few that is not...

  • More on Protease Inhibitors and Corticosteroids

    Susa Coffey's picture

    It has been demonstrated previously that ritonavir significantly increases serum levels of inhaled and intranasal fluticasone and that coadministration with fluticasone should be avoided. Few studies have examined interactions between PIs and other corticosteroids. At the 19th...

  • More on Interactions between Darunavir and Pravastatin: To Use or Not to Use?

    Susa Coffey's picture

    Recommendations for coadministration of pravastatin with darunavir have been based on a small PK study that showed substantial intersubject variability in the impact of interactions between the two drugs.[1] In that study, concurrent administration of pravastatin (40 mg, single...

  • ARV Interactions with HCV Serine Protease Inhibitors

    Susa Coffey's picture

    Boceprevir and telaprevir, the hepatitis C virus (HCV) serine protease inhibitors, are likely to play important roles in the treatment of individuals with HIV/HCV coinfection, as well as in persons with HCV monoinfection. However, both boceprevir and telaprevir are inhibitors and substrates of...

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