Page 197 - HIV/AIDS Guidelines

Table 15a. Drug Interactions between Protease Inhibitors* and Other Drugs (Page 9 of 11)

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

ATV/r, ATV/r ↑ rosuvastatin AUC 213% and Titrate rosuvastatin dose carefully and use the lowest
LPV/r C max ↑ 600% necessary dose. Do not exceed 10 mg rosuvastatin
LPV/r ↑ rosuvastatin AUC 108% and daily.
C max ↑ 366%

DRV/r rosuvastatin AUC ↑ 48% and Titrate rosuvastatin dose carefully and use the lowest
C max ↑ 139% necessary dose while monitoring for toxicities.
Rosuvastatin
FPV +/- No significant effect on rosuvastatin No dosage adjustment necessary
RTV

SQV/r No data available Titrate rosuvastatin dose carefully and use the lowest
necessary dose while monitoring for toxicities.

TPV/r rosuvastatin AUC ↑ 26% and No dosage adjustment necessary.
C max ↑ 123%

Simvastatin All PIs Significant ↑ simvastatin level; Contraindicated. Do not coadminister.
SQV/r 400 mg/400 mg BID
↑ simvastatin AUC 3059%

Narcotics/Treatment for Opioid Dependence

ATV buprenorphine AUC ↑ 93% Do not coadminister buprenorphine with unboosted
c
norbuprenorphine AUC ↑ 76% ATV.
↓ ATV possible
ATV/r buprenorphine AUC ↑ 66% Monitor for sedation. Buprenorphine dose reduction
c
norbuprenorphine AUC ↑ 105% may be necessary.
DRV/r buprenorphine: no significant effect No dosage adjustment necessary. Clinical monitoring is
c
norbuprenorphine AUC ↑ 46% and C min recommended.
↑ 71%
Buprenorphine
FPV/r buprenorphine: no significant effect No dosage adjustment necessary. Clinical monitoring is
c
norbuprenorphine AUC ↓ 15% recommended.
LPV/r No significant effect No dosage adjustment necessary
TPV/r buprenorphine: no significant effect Consider monitoring TPV level.
c
norbuprenorphine AUC, C max , and
C min ↓ 80%
TPV C min ↓ 19%–40%

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents K-27

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