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Table 15b. Drug Interactions between Non-Nucleoside Reverse Transcriptase Inhibitors* and Other
Drugs (Page 3 of 6)

Effect on NNRTI or
Concomitant Drug NNRTI a Concomitant Drug Dosing Recommendations and Clinical
Class/Name Comments
Concentrations
Antimycobacterials, cont’d
ETR clarithromycin AUC ↓ 39% Consider alternative agent, such as azithromycin, for
ETR AUC ↑ 42% MAC prophylaxis and treatment.
NVP clarithromycin AUC ↓ 31% Monitor for effectiveness or use alternative agent,
Clarithromycin, cont’d such as azithromycin, for MAC prophylaxis and
treatment.

RPV ↔ clarithromycin expected Consider alternative macrolide, such as azithromycin,
↑ RPV possible for MAC prophylaxis and treatment.

EFV rifabutin ↓ 38% Dose: rifabutin 450–600 mg once daily or 600 mg
three times a week if EFV is not coadministered with a
PI.

ETR rifabutin and metabolite AUC ↓ If ETR is used with an RTV-boosted PI, rifabutin
17% should not be coadministered.
ETR AUC ↓ 37%
Rifabutin Dose: rifabutin 300 mg once daily if ETR is not
coadministered with an RTV-boosted PI.
NVP rifabutin AUC ↑ 17% and No dosage adjustment necessary. Use with caution.
metabolite AUC ↑ 24%
NVP C min ↓ 16%

RPV RPV AUC ↓ 46% Contraindicated. Do not coadminister.
EFV EFV AUC ↓ 26% Maintain EFV dose at 600 mg once daily and monitor
for virologic response. Consider therapeutic drug
monitoring.
Some clinicians suggest EFV 800 mg dose in
Rifampin patients who weigh more than 60 kg.
ETR Significant ↓ ETR possible Do not coadminister.
NVP NVP ↓ 20%–58% Do not coadminister.
RPV RPV AUC ↓ 80% Contraindicated. Do not coadminister.

Rifapentine EFV, ETR, ↓ NNRTI expected Do not coadminister.
NVP, RPV

Benzodiazepines
Alprazolam EFV, ETR, No data Monitor for therapeutic effectiveness of alprazolam.
NVP, RPV
Diazepam ETR ↑ diazepam possible Decreased dose of diazepam may be necessary.
Lorazepam EFV lorazepam C max ↑ 16%, No dosage adjustment necessary.
AUC ↔

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents K-32

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