Antimalarial Drugs & ARVs

Drug-drug interactions between Antimalarial Drugs & ARVs

Legend
  Potential increased exposure of the antimalarial drug
  Potential decreased exposure of the antimalarial drug
No significant effect
D  Potential decreased exposure of ARV drug
E  Potential elevated exposure of ARV drug

ATV/c    ATV co-formulated with COBI (300/150 mg qd)
DRV/c    DRV co-formulated with COBI (800/150 mg qd)

Numbers refer to increased or decreased AUC as observed in drug-drug interaction studies

Interactions with ZDV
Amodiaquine, atovaquone, primaquine, pyrimethamine, sulfadoxine (potential additive hematological toxicity)

Comments

  1. Liver toxicity
  2. Take with high fat meal, consider dose increase
  3. ECG monitoring is recommended
  4. Chloroquine concentrations may increase, but to a moderate extent. No dose adjustment is required but monitor toxicity
  5. Chloroquine concentrations may increase or decrease. No dose adjustment is required but monitor toxicity and efficacy
  6. Chloroquine concentrations may decrease, but to a moderate extent. No dose adjustment is required but monitor efficacy
  7. Both drugs can induce QT interval prolongation (only at supratherapeutic dose for RPV)
  8. Increase of haemotoxic metabolites

Further Information

For additional drug-drug interactions and for more detailed pharmacokinetic interaction data and dosage adjustments, please refer to http://www.hiv-druginteractions.org (University of Liverpool)