Page 203 - HIV/AIDS Guidelines

Table 15b. Drug Interactions between Non-Nucleoside Reverse Transcriptase Inhibitors* and Other
Drugs (Page 4 of 6)

Effect on NNRTI or
Concomitant Drug NNRTI a Concomitant Drug Dosing Recommendations and Clinical
Class/Name Comments
Concentrations
Midazolam EFV Significant ↑ midazolam Do not coadminister with oral midazolam.
expected
Parenteral midazolam can be used with caution as a
single dose and can be given in a monitored
situation for procedural sedation.

Triazolam EFV Significant ↑ triazolam Do not coadminister.
expected
Cardiac Medications
Dihydropyridine calcium EFV, NVP ↓ CCBs possible Titrate CCB dose based on clinical response.
channel blockers (CCBs)
EFV diltiazem AUC ↓ 69%
↓ verapamil possible
Diltiazem Titrate diltiazem or verapamil dose based on clinical
Verapamil NVP ↓ diltiazem or verapamil response.
possible
Corticosteroids

EFV, ETR, ↓ EFV, ETR, NVP possible Consider alternative corticosteroid for long-term use.
NVP If dexamethasone is used with NNRTI, monitor
virologic response.
Dexamethasone
RPV Significant ↓ RPV possible Contraindicated with more than a single dose of
dexamethasone.
Hepatitis C NS3/4A - Protease Inhibitors
Boceprevir EFV EFV AUC ↑ 20% Coadministration is not recommended.
boceprevir AUC ↓ 19%,
C min ↓ 44%

Telaprevir EFV EFV AUC ↔ Increase telaprevir dose to 1125 mg q8h.
telaprevir AUC ↓ 26%,
C min ↓ 47%
With TDF:
EFV AUC ↓ 15%–18%,
telaprevir AUC ↓ 18%–20%
Herbal Products
St. John’s wort EFV, ETR, ↓ NNRTI Do not coadminister.
NVP, RPV

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents K-33

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