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| Positively Aware January/February 2007 |
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Drug Interactions
Chart
An abbreviated, at-a-glance guide to
HIV drug interactions
compiled by Enid Vázquez |
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Please see the drug’s page for details, or refer to the manufacturer’s package insert for a full comprehensive list of potential drug interactions. Also, make your pharmacist and health care providers aware of any drug that you add. Some interactions are more serious than others; some drugs may only require a dose adjustment, while others may either render the drug completely ineffective, or worse, lead to a potentially fatal reaction. Discuss any changes, however minor, with your healthcare providers, including your pharmacist, since small reactions may become serious. Look up your drugs with “Check my meds” at www.aidsmeds.com, which lists the effect of food as well as interactions for medications. The University of Liverpool also has an interactive database that allows you to look up antiretroviral drug interactions and has PDF charts of interactions between antiretrovirals and other drugs. Remember, brand names are usually capitalized, while generic names are not. Visit www.hiv-druginteractions.org.
| Nucleoside Reverse Transcriptase Inhibitors (also called nucleoside analogs, NRTIs, or nukes) |
| Potential drug class interactions |
Pancreatitis, enlarged, fatty liver and lactic acidosis. |
| Combivir (Retrovir and Epivir) |
See Epivir and Retrovir. Do not take Retrovir or Epivir while taking Combivir since these medications are already in Combivir. |
| Emtriva (emtricitabine, FTC) |
No significant drug interactions. |
Epivir
(lamivudine, 3TC) |
No significant drug interactions. |
| Epzicom (Epivir and Ziagen) |
See Epivir and Ziagen. Do not take Epivir or Ziagen while taking Epzicom since these medications are already in Epzicom. |
| Retrovir (zidovudine or ZDV, AZT) |
Amphotericin B, Benemid, Biaxin, Cytovene, dapsone, Depakote, Dilantin, doxorubicin, flucytosine, ganciclovir, hydroxyurea, interferon-alpha, Mycobutin, pentamidine, Rebetol, ribavirin, rifampin, sulfadiazine, Valcyte, Vitrasert and Zerit. |
| Trizivir (Epivir, Retrovir, and Ziagen) |
See Epivir, Retrovir and Ziagen. Do not take Retrovir, Epivir or Ziagen while taking Trizivir, since these medications are already in Trizivir. |
| Truvada (Viread and Emtriva) |
See Emtriva and Viread. Do not take Emtriva or Viread while taking Truvada, since these medications are already in Truvada. |
| Videx & Videx EC (didanosine, ddI) |
Alcohol, Cytovene, dapsone, HIV protease inhibitors, hydroxyurea, methadone, NebuPent, Nizoral, Rescriptor, Retrovir, ribavirin, Sporanox, Tagamet, Viread and Zerit. |
| Viread (tenofovir disoproxil fumarate, TDF) |
Kaletra, Norvir, Reyataz, Videx and Videx-EC. |
| Zerit (stavudine, d4T) |
Cytovene, dapsone, Foscavir, Fungizone, pentamidine, Retrovir, Valcyte, Videx and Videx-EC and Vitrasert. |
| Ziagen (abacavir sulfate, ABC) |
Alcohol. |
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| Non-Nucleoside Reverse Transcriptase Inhibitors (also called non-nucleoside analogs, NNRTIs, or non-nukes) |
| Potential drug class interactions |
HIV protease inhibitors; methadone. |
| Rescriptor (delavirdine, DLV) |
Adalat, Agenerase, certain amphetamines and antiarrhythmic drugs, Biaxin, birth control pills, Cafergot, carbamazepine (Tegretol and others), Cialis, Coumadin, Crixivan, dapsone, Desyrel, Dilantin, fluticasone (Advair, Flonase, Flovent), Halcion, immunosuppressants, Invirase, Kaletra, Levitra, Lexiva, methadone, Methergine, Mevacor, Mycobutin, Norvasc, Norvir, Orap, phenobarbital, pimozide, Plendil, Procardia, Propulsid, quinidine, rifampin, Reyataz, St. John’s wort, Viagra, Viracept, Versed, Wigraine, Xanax and Zocor. |
| Sustiva (efavirenz, EFV) |
Biaxin, birth control pills, Cafergot, carbamazepine (Tegretol and others), Coumadin, Crixivan, Dilantin, Halcion, Invirase, Kaletra, Lexiva, methadone, Methergine, Mycobutin, Norvir, Reyataz, rifabutin, rifampin, phenobarbital, Sporanox, St. John’s wort, Vfend, Versed and Wigraine. |
| Viramune (nevirapine, NVP) |
Biaxin, birth control pills, calcium channel blockers, Coumadin, flucanozole, Halcion, HIV protease inhibitors, ketoconazole, methadone, prednisone, rifabutin, rifampin and St. John’s wort. |
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| Dual-class Fixed Dose Combination |
| Atripla (Sustiva/Truvada) |
See Sustiva and Truvada (Emtriva/Viread). Do not take Sustiva or Truvada (Emtriva/Viread) with Atripla, since these medications are already in Atripla. |
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| Protease inhibitors (PIs) |
| Potential drug class interactions |
Cardiac medications, cholesterol medication, migraine medications, erectile dysfunction drugs, sedatives, tuberculosis drugs. |
| Agenerase (amprenavir) |
See Lexiva. Birth control pills, antiarrhythmics, antibiotics, anticoagulants, antidepressants, antifungals, blood pressure medications, Cafergot, cholesterol medications, Cialis, Cordarone, D.H.E. 45, Halcion, drugs for heartburn or acid reflux, immunosuppresants, Kaletra, Lescol, Levitra, Lipitor, Methergine, Mevacor, Orap, Pravachol, quinidine, Rescriptor, rifampin, Rythmol, sedatives, steroids, drugs for seizures, St. John’s wort, Sustiva, Tambocor, Versed, Viagra, Viracept, vitamin E, Wigraine and Zocor. |
Aptivus (tipranavir)
(must be taken with Norvir;
see Norvir) |
Aptivus/Norvir interacts with many other drugs, so it is important to tell your healthcare professonial all the medications you are taking. See the manufacturer package insert for the most complete list. Agenerase, Antabuse, birth control pills, Cafergot, carbamazepine (Tegretol and others), Cialis, Cordarone, Coumadin, D.H.E. 45, Desyrel, Diflucan, Dilantin, Flagyl, fluticasone (Advair, Flonase, and Flovent), garlic supplements, Halcion, immunosuppressants, Kaletra, ketoconazole, Lescol, Levitra, Lipitor, methadone, Methergine, Mevacor, Norvasc, Orap, Paxil, phenobarbital, Pravachol, Procardia, quinidine, rifabutin, Rifadin, Rythmol, St. John’s wort, Sporanox, Tambocor, Versed, Viagra, Vfend, Wigraine, Zocor, and Zoloft. |
| Crixivan (indinavir sulfate) |
Birth control pills, Cafergot, Cialis, D.H.E. 45, fluticasone (Advair, Flonase, Flovent), garlic supplements, Halcion, Lescol, Levitra, Lipitor, methadone, Methergine, Mevacor, Mycobutin, Nizoral, Orap, Pravachol, Rescriptor, Reyataz, rifampin, Rythmol, Sporanax, St. John’s wort, Sustiva, Tambocor, Versed, Viagra, Viramune, Wigraine and Zocor. |
Invirase (saquinavir)
(must be taken with Norvir;
see Norvir)
|
Birth control pills, Cafergot, Cialis, Crixivan, D.H.E. 45, Desyrel, fluticasone (Advair, Flonase, Flovent), garlic supplements, Halcion, Kaletra, Lescol, Levitra, Lipitor, Methergine, Mevacor, Mycobutin, Nizoral, Norvir, Pravachol, rifampin, Rescriptor, Rythmol, St. John’s wort, Sporonox, Sustiva, Tambocor, Versed, Viracept, Viagra, Viramune, Wigraine and Zocor. |
| Kaletra (lopinavir/ritonavir) |
Antabuse, Biaxin, birth control pills, Cafergot, carbamazepine (Tegretol and others), Cialis, Coumadin, D.H.E. 45, Desyrel, digoxin, Flagyl, fluticasone (Advair, Flonase, Flovent), garlic supplements, Halcion, Lescol, Levitra, Lexiva, Lipitor, Mepron, methadone, Methergine, Mevacor, Mycobutin, Orap, phenobarbital, phenytoin (Dilantin and others), Pravachol, Procardia, rifabutin, rifampin, Retrovir, St. John’s wort, Sporanox, steroids (especially Decadron), Sustiva, transplant medicines, Versed, Vfend, Viagra, Videx, Viramune, Wigraine, Ziagen and Zocor. |
| Lexiva (fos-amprenavir calcium) |
Antabuse, Cafergot, certain calcium channel blockers, Cialis, Desyrel, D.H.E. 45, Flagyl, fluticasone (Advair, Flonase, Flovent), Halcion, Kaletra, Lipitor, Lescol, Levitra, Lexiva, Mevacor, Orap, Pravachol, Rescriptor, Rythmol, Methergine, rifampin, St. John’s wort, Sustiva, Tambocor, Versed, Viagra, warfarin, Wigraine and Zocor. |
| Norvir (ritonavir) |
See the manufacturer package insert for the most complete list. Alcohol, Antabuse, Biaxin, birth control pills, Cafergot, Cialis, D.H.E. 45, Desyrel, Ecstasy, Flagyl, fluticasone (Advair, Flonase, Flovent), garlic supplements, GHB, Halcion, Lescol, Levitra, Lipitor, Methergine, Mevacor, Orap, Pravachol, rifampin, Rythmol, St. John’s wort, Tambocor, tobacco, Versed, Viagra, Wigraine and Zocor. |
| Prezista |
Birth control pills, Cafergot, carbamazepine (Tegretol and others), Cialis, Cordarone, Coumadin, D.H.E. 45, Desyrel, Dilantin, fluticasone (Advair, Flonase, and Flovent), garlic supplements, Halcion, immunosuppressants, ketoconazole, Levitra, Lipitor, methadone, Methergine, Mevacor, Norvasc, Orap, Paxil, phenobarbital, Pravachol, Procardia, rifabutin, Rifadin, Rythmol, St. John’s wort, Sporanox, Tambocor, Versed, Vfend, Viagra, Wigraine, Zocor, and Zoloft. |
| Reyataz (atazanavir sulfate) |
Aciphex (or any proton-pump inhibitor), Cialis, Cafergot, D.H.E. 45, Desyrel, fluticasone (Advair, Flonase, Flovent), garlic supplements, Halcion, Lescol, Levitra, Lipitor, Methergine, Mevacor, Mylanta, Nexium, Orap, Pravachol, Prevacid, Prilosec-OTC, rifabutin, rifampin, Rythmol, St. John’s wort, Sustiva, Tambocor, Versed, Viagra, Videx and Videx-EC, Viread, Wigraine and Zocor |
| Viracept (nelfinavir) |
Cafergot, carbamazepine (Tegretol and others), Cialis, Cordarone, Crixivan, D.H.E. 45, Desyrel, fluticasone (Advair, Flonase, Flovent), garlic supplements, Halcion, Lescol, Levitra, Lipitor, Methergine, Mevacor, Mycobutin, phenobarbital, phenytoin, Pravachol, Prilosec-OTC, rifampin, St. John’s wort, Versed, Viagra, Wigraine and Zocor. |
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| Entry (fusion) Inhibitor |
| Fuzeon (enfuvirtide, T-20) |
None reported. |
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