DDIs, Prescribing, Overview

Drug-drug interactions and other prescribing issues in PLWH

ARVs are recognised to be amongst the therapeutic agents with the highest potential for drug-drug interactions (DDIs) as these drugs can be both a victim (affected by other drugs) and/or a perpetrator (affect other drugs) of DDIs. Given the life-long ART, DDIs are practically unavoidable in PLWH with co-morbid conditions. Thus, the potential for DDIs should be considered systematically when selecting an ART regimen or when any new medicine is co-administered to existing ART with particular attention to adjust dosage and perform clinical monitoring when needed.

The DDIs profiles between ARVs and coadministered medicines within a therapeutic class are also presented in the corresponding Co-morbidities section and Viral Hepatitis Co-infection section.

Detailed information on DDIs can be found on the University of Liverpool DDIs websites: http://www.hiv-druginteractions.org and http://www.hep-druginteractions.org

Age-related physiological changes and co-morbidities predispose elderly PLWH to inappropriate drug use or dosing in addition to DDIs [1].
Besides highlighting the most common DDIs, this section also provides guidance on how to adjust drug dosing in case of liver or renal impairment, considerations for those with swallowing difficulties and what to consider when prescribing drugs in elderly PLWH including the top ten drug classes to avoid.