Page 196 - HIV/AIDS Guidelines

Table 15a. Drug Interactions between Protease Inhibitors* and Other Drugs (Page 8 of 11)

Concomitant Effect on PI or Concomitant Drug Dosing Recommendations and Clinical
Drug PI Concentrations Comments

FPV/r ethinyl estradiol AUC ↓ 37% Use alternative or additional contraceptive method.
norethindrone AUC ↓ 34%
LPV/r ethinyl estradiol AUC ↓ 42% Use alternative or additional contraceptive method.
norethindrone AUC ↓ 17%
SQV/r ↓ ethinyl estradiol Use alternative or additional contraceptive method.

TPV/r ethinyl estradiol AUC ↓ 48% Use alternative or additional contraceptive method.
norethindrone: no significant change
Hormonal
Contraceptives PIs without RTV
ATV ethinyl estradiol AUC ↑ 48% Use oral contraceptive that contains no more than 30
norethindrone AUC ↑ 110% mcg of ethinyl estradiol or use alternative contraceptive
method.
Oral contraceptives containing less than 25 mcg of
ethinyl estradiol or progestins other than norethindrone
or norgestimate have not been studied. b

FPV With APV: ↑ ethinyl estradiol and Use alternative method.
↑ norethindrone C min ; APV C min ↓ 20%

HMG-CoA Reductase Inhibitors
ATV +/- ↑ atorvastatin possible Titrate atorvastatin dose carefully and use lowest dose
RTV necessary.
DRV/r DRV/r + atorvastatin 10 mg similar to Titrate atorvastatin dose carefully and use the lowest
FPV +/- atorvastatin 40 mg administered alone; necessary dose. Do not exceed 20 mg atorvastatin daily.
RTV FPV +/– RTV ↑ atorvastatin AUC 130%–
Atorvastatin SQV/r 153%;
SQV/r ↑ atorvastatin AUC 79%
LPV/r LPV/r ↑ atorvastatin AUC 488% Use with caution and use the lowest atorvastatin dose
necessary.

TPV/r ↑ atorvastatin AUC 836% Do not coadminister.

Lovastatin All PIs Significant ↑ lovastatin expected Contraindicated. Do not coadminister.
Pitavastatin All PIs ATV ↑ pitavastatin AUC 31% and No dose adjustment necessary.
C max ↑ 60%
ATV: no significant effect
DRV ↓ pitavastatin AUC 26%
DRV: no significant effect
LPV/r ↓ pitavastatin AUC 20%
LPV: no significant effect

DRV/r pravastatin AUC ↑ 81% Use lowest possible starting dose with careful
monitoring.
Pravastatin LPV/r pravastatin AUC ↑ 33% No dose adjustment necessary.

SQV/r pravastatin AUC ↓ 47%–50% No dose adjustment necessary.

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents K-26

Downloaded from http://aidsinfo.nih.gov/guidelines on 12/8/2012 EST.