Bronchodilators & ARVs

Drug-drug interactions between bronchodilators (for COPD) & ARVs

 Legend
  Potential elevated exposure of the bronchodilator    
↓  Potential decreased exposure of the bronchodilator
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

ICS = inhaled corticosteroids 
LABA = long-acting β2 agonists 
LAMA = long-acting muscarinic antagonists    
MX = methylxanthines
PD4 = phosphodiesterase 4 inhibitors  
SABA = short-acting β2 agonists
SAMA = short-acting muscarinic antagonists


Interactions with ZDV
No clinically relevant interactions expected with ZDV and bronchodilators


Comments

  1. Caution as both drugs can induce QT interval prolongation
  2. Exposure can be increased up to 2-fold however this increase does not raise any concerns based on indacaterol's safety data
  3. ECG monitoring is recommended
  4. Increase in concentration of active metabolite observed with RTV 100 mg bid alone but without significant effect on adrenal function. Caution is still warranted, use the lowest possible corticosteroid dose and monitor for corticosteroid side effects

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).