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

Effect on NNRTI or
Concomitant Drug NNRTI a Concomitant Drug Dosing Recommendations and Clinical
Class/Name Comments
Concentrations
Narcotics/Treatment for Opioid Dependence

EFV buprenorphine AUC ↓ 50% No withdrawal symptoms reported. No dosage
b
norbuprenorphine AUC ↓ 71% adjustment recommended, but monitor for
withdrawal symptoms.
Buprenorphine
ETR buprenorphine AUC ↓ 25% No dosage adjustment necessary.

NVP No significant effect No dosage adjustment necessary.
EFV methadone AUC ↓ 52% Opioid withdrawal common; increased methadone
dose often necessary.

ETR No significant effect No dosage adjustment necessary.
Methadone NVP methadone AUC ↓ 37%–51% Opioid withdrawal common; increased methadone
NVP: no significant effect dose often necessary.
c
RPV R-methadone AUC ↓ 16% No dosage adjustment necessary, but monitor for
withdrawal symptoms.
Phosphodiesterase Type 5 (PDE5) Inhibitors

ETR sildenafil AUC ↓ 57% May need to increase sildenafil dose based on
clinical effect.
Sildenafil
RPV sildenafil ↔ No dosage adjustment necessary.
Tadalafil ETR ↓ tadalafil possible May need to increase tadalafil dose based on
clinical effect.

Vardenafil ETR ↓ vardenafil possible May need to increase vardenafil dose based on
clinical effect.

Miscellaneous Interactions
Atovaquone/proguanil EFV ↓ atovaquone AUC 75% No dosage recommendation. Consider alternative
↓ progaunil AUC 43% drug for malaria prophylaxis, if possible.
a
Approved dose for RPV is 25 mg once daily. Most PK interaction studies were performed using 75 to 150 mg per dose.
b
Norbuprenorphine is an active metabolite of buprenorphine.
c
R-methadone is the active form of methadone.
Key to Abbreviations: ARV = antiretroviral, AUC = area under the curve, BID = twice daily, CCB = calcium channel blocker, C max = maximum
plasma concentration, C min = minimum plasma concentration, DLV = delavirdine, DMPA = depomedroxyprogesterone acetate,
EFV = efavirenz, ETR = etravirine, FDA = Food and Drug Administration, INR = international normalized ratio, MAC = Mycobacterium avium
complex, NNRTI = non-nucleoside reverse transcriptase inhibitor, NVP = nevirapine, PDE5 = phosphodiesterase type 5, PI = protease inhibitor,
PPI = proton pump inhibitor, RPV = rilpivirine, RTV = ritonavir, TDF = tenofivir

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents K-35

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