HIV-protease inhibitors(continued)
▶Darunavirincreases the risk of rash when given with
raltegravir.oStudy
▶Fosamprenavir(boosted with ritonavir) decreases the
exposure toraltegravirandraltegravirdecreases the exposure
tofosamprenavir(boosted with ritonavir). Avoid.rStudy
▶Tipranavir(boosted with ritonavir) is predicted to decrease the
exposure toraltegravir(high-dose). Avoid.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
toranolazine. Avoid.rStudy→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
toreboxetine. Avoid.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
toregorafenib. Avoid.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
torepaglinide.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
toretinoids(alitretinoin). Adjustalitretinoindose.o
Theoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
toribociclib. Avoid or adjustribociclibdose.oStudy→
Also seeTABLE 9p. 849
▶HIV-protease inhibitors(atazanavir, darunavir, fosamprenavir,
lopinavir, saquinavir, tipranavir)(boosted with ritonavir)
increase the exposure torifabutin. Monitor and adjust dose.
rStudy
▶Ritonavirmarkedly increases the exposure torifabutin. Avoid
or adjust dose.rStudy
▶Rifampicinis predicted to moderately to markedly decrease
the exposure toHIV-protease inhibitors(atazanavir, darunavir,
fosamprenavir, lopinavir, saquinavir). Avoid.rStudy
▶Rifampicinslightly decreases the exposure toritonavir.r
Study
▶Rifampicinis predicted to decrease the exposure totipranavir.
Avoid.rStudy
▶Ritonaviris predicted to increase the exposure toriociguat.
Avoid.oTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
torisperidone. Adjust dose.oStudy→Also seeTABLE 9
p. 849
▶Ritonavirmoderately increases the exposure torivaroxaban.
Avoid.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
toruxolitinib. Adjust dose and monitor side effects.o
Study
▶HIV-protease inhibitorsare predicted to increase the exposure
tosaxagliptin.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
tosimeprevir. Avoid.rStudy
▶HIV-protease inhibitorsare predicted to increase the
concentration ofsirolimus. Avoid.rStudy
▶Tipranaviris predicted to decrease the exposure tosofosbuvir.
Avoid.rTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
tosolifenacin. Adjustsolifenacinortamsulosin with solifenacin
dose; avoid in hepatic and renal impairment.rStudy
▶HIV-protease inhibitorsare predicted to moderately increase
the exposure toSSRIs(dapoxetine). Avoid potent inhibitors of
CYP3A4 or adjustdapoxetinedose.rStudy
▶St John’s Wortis predicted to decrease the exposure toHIV-
protease inhibitors. Avoid.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
tostatins(atorvastatin). Avoid or adjust dose and monitor
rhabdomyolysis.rStudy
▶HIV-protease inhibitorsslightly to moderately increase the
exposure tostatins(rosuvastatin). Avoid or adjust dose.r
Study
▶HIV-protease inhibitorsare predicted to increase the exposure
tostatins(simvastatin). Avoid.rStudy
▶HIV-protease inhibitorsare predicted to slightly increase the
exposure tosunitinib. Avoid or adjustsunitinibdose.o
Study→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the
concentration oftacrolimus. Monitor and adjust dose.r
Study▶HIV-protease inhibitorsare predicted to increase the exposure
totaxanes(cabazitaxel). Avoid.rStudy
▶HIV-protease inhibitorsare predicted to moderately increase
the exposure totaxanes(docetaxel). Avoid or adjust dose.
rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
totaxanes(paclitaxel).rTheoretical
▶HIV-protease inhibitorsare predicted to increase the
concentration oftemsirolimus. Avoid.rTheoretical
▶HIV-protease inhibitors(atazanavir, darunavir)increase the
exposure totenofovir alafenamide. Avoid.oStudy
▶Tipranaviris predicted to affect the exposure totenofovir
alafenamide. Avoid.oTheoretical
▶Ritonaviris predicted to decrease the exposure totheophylline.
Adjust dose.oStudy
▶HIV-protease inhibitorsare predicted to markedly increase the
exposure toticagrelor. Avoid.rStudy
▶Ritonavirmoderately decreases the exposure totizanidine.
nStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
totofacitinib. Adjusttofacitinibdose.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
totolterodine. Avoid.rStudy→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
totolvaptan. Adjust dose.rStudy
▶HIV-protease inhibitors(lopinavir, ritonavir, saquinavir)are
predicted to increase the exposure totopotecan.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
totoremifene.oTheoretical→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
totrabectedin. Avoid or adjust dose.rTheoretical
▶HIV-protease inhibitors(lopinavir, ritonavir, saquinavir)are
predicted to increase the concentration oftrametinib.
oTheoretical
▶HIV-protease inhibitorsare predicted to moderately increase
the exposure totrazodone. Avoid or adjust dose.o
Study
▶HIV-protease inhibitors(ritonavir, tipranavir)are predicted to
increase the exposure totricyclic antidepressants.o
Theoretical
▶HIV-protease inhibitors(atazanavir, darunavir, fosamprenavir,
lopinavir, saquinavir, tipranavir)are predicted to increase the
exposure toulipristal. Avoid if used for uterinefibroids.r
Study
▶Ritonavirdecreases the efficacy ofulipristal. For FSRH
guidance, seeContraceptives, interactionsp. 497.r
Anecdotal
▶HIV-protease inhibitorsare predicted to increase the exposure
tovemurafenib.rTheoretical→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
tovenetoclax. Avoid potent inhibitors of CYP3A4 or adjust
venetoclaxdose.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
tovenlafaxine.oStudy→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
tovinca alkaloids.rTheoretical→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
tovitamin D substances(paricalcitol).oStudy
▶Atazanavir(boosted with ritonavir) increases the
concentration ofvoxilaprevir. Avoid.rStudy
▶Lopinaviris predicted to increase the concentration of
voxilaprevir. Avoid.rTheoretical
▶Tipranavirslightly decreases the exposure tozidovudine.
Avoid.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
tozopiclone. Adjust dose.oTheoretical
Homatropine→seeTABLE 10p. 849 (antimuscarinics)
Hormone replacement therapy
▶Antiepileptics(carbamazepine, eslicarbazepine, fosphenytoin,
oxcarbazepine, perampanel, phenobarbital, phenytoin,
primidone, rufinamide, topiramate)are predicted to decrease
the effects ofhormone replacement therapy.oAnecdotal
▶Hormone replacement therapyis predicted to alter the
exposure toantiepileptics(lamotrigine).oTheoretical932 HIV-protease inhibitors—Hormone replacement therapy BNFC 2018 – 2019
Interactions|Appendix 1A1