Anti-malarial Drugs & ARVs

Legend

↑                  Potential elevated 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)
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

Interactions with ABC, FTC, 3TC, ZDV

ABC:  no clinically relevant interactions expected.
FTC:   increased FTC exposure with pyrimethamine, sulfadoxine.
3TC:   increased 3TC exposure with pyrimethamine, sulfadoxine.
ZDV:   potential additive haematological toxicity with amodiaquine, atovaquone, primaquine, pyrimethamine, sulfadoxine.

Interactions with ibalizumab

None

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/hydroxychloroquine 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. Caution as both drugs can induce QT interval prolongation.
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)