Anti-infective Drugs for OIs and STIs and ARVs
Legend
↑ Potential elevated exposure of the antidepressant
↓ Potential decreased exposure of the antidepressant
↔ 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)
CAB/RPV CAB and RPV im long acting injections
(PK and/or QT interactions shown are with RPV)
Numbers refer to increased or decreased AUC as observed in drug-drug interaction studies
Antibacterial
Refer to the Anti-tuberculosis table for interactions with amikacin, moxifloxacin and rifabutin.
Refer to the Anti-malarial table for interactions with clindamycin and doxycycline.
Antiparasitic
Refer to the Anti-malarial table for interactions with atovaquone, primaquine and pyrimethamine.
Interactions with ABC, FTC, 3TC, ZDV
ABC: no clinically relevant interactions expected.
FTC: potential additive renal toxicity with sulfadiazine and flucytosine.
FTC: potential increased FTC exposure with trimethoprim, but no dose adjustment required in patients with
normal renal function.
3TC: potential additive renal toxicity with sulfadiazine and flucytosine.
3TC: increased 3TC exposure (43%) with trimethoprim, but no dose
adjustment required in patients with normal renal function.
Some trimethoprim/sulfamethoxazole liquid preparations may contain sorbitol which decreases the
bioavailability of lamivudine solutions.
ZDV: potential risk of additive haematoxicity with brincidofovir and flucytosine.
ZDV: increased ZDV exposure (20%) with ganciclovir.
ZDV: decreased ZDV exposure (12%) with clarithromycin.
ZDV: potential increased risk of ZDV adverse reactions with trimethoprim, sulfamethoxazole, amphotericin B
and flucytosine.
ZDV: increased ZDV exposure (74%) with fluconazole. Routine ZDV dose modification not required, but
monitor for potential ZDV toxicity.
ZDV: no PK interaction observed with dapsone but potential increased risk of ZDV adverse reactions.
ZDV: potential increased risk of ZDV adverse reactions with pentamidine (but not with aerosolised
pentamidine at doses used in prophylaxis).
Interactions with cabotegravir (oral)
None
Interactions with ibalizumab
None
Comments
- TDF should be avoided with concurrent or recent use of a nephrotoxic agent. If co-administration is unavoidable, monitor renal function closely.
- ECG monitoring is recommended.
- Caution as both drugs can induce QT interval prolongation.
- Co-administration could potentially increase haematological toxicity. Monitor haematological parameters and consider dose reduction if required.
- Renal impairment and sometimes fatal renal failure have been described with meglumine antimoniate treatment. Close monitoring of renal function is warranted.
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)