Anticoagulants/Antiplatelet Agents & ARVs

Drug-drug interactions between Anticoagulants/Antiplatelets & ARVs

 

 

Legend

  Potential elevated exposure of the anticoagulant/antiplatelet agent     
  Potential decreased exposure of the anticoagulant/antiplatelet agent
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)


Interactions with ZDV

No clinically relevant interactions expected with ZDV and anticoagulants or platelet agents

Comments

  1. US label suggests to use apixaban at a reduced dose (2.5 mg twice daily) if needed
  2. Unboosted ATV predicted to increase the anticoagulant, monitor INR and adjust the anticoagulant dosage accordingly
  3. Decreased conversion to active metabolite leading to non-responsiveness to clopidogrel. An alternative to clopidogrel should be considered.
  4. Increase in amount of active metabolite via induction of CYP3A4 and CYP2B6
  5. No pharmacokinetic interaction is expected, however, abacavir has been shown to potentiate platelet activation in vitro and may reduce the pharmacodynamic effect of clopidogrel
  6. Unboosted ATV predicted to increase dipyridamole exposure due to UGT1A1 inhibition
  7. Reduced active metabolite, but without a significant reduction in prasugrel activity

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).