Interactions

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ARV

Drug 2

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Drug 1 dose (field_drug_1_dose)

Drug doses

ID	Title	drug 1 Sort descending	drug 1 dose	drug 1 effect	drug 2	drug 2 dose	drug 2 effect	Clinical Effects	Color	Clinical Bottom Line	Management	Alt Agents
6578	Darunavir Dabigatran 963	Darunavir			Dabigatran			Potential for increased bleeding risk	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative anticoagulant
6594	Darunavir Oxcarbazepine 979	Darunavir			Oxcarbazepine			Potential loss of antiviral efficacy	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Consider alternate anticonvulsants. If coadministering, use caution and clinical monitoring is recommended
6610	Darunavir Drospirenone / Ethinyl estradiol 995	Darunavir			Drospirenone / Ethinyl estradiol			Potential for increased risk of drospirenone adverse effects (hyperkalemia) or decreased contraceptive efficacy	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Clinical monitoring is recommended
6626	Darunavir CsA 1011	Darunavir		Not studied	Cyclosporine		Not studied (may increase cyclosporine levels)	Potential for increased risk of cyclosporine adverse effects (supratherapeutic immunosuppression, renal toxicity)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, initiate lower dose of immunosuppressant, monitor concentrations and toxicity, consult with specialist, and adjust dose as necessary
6642	Darunavir Metoprolol 1027	Darunavir			Metoprolol			Potential for increased risk of metoprolol adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, use caution and clinical monitoring is recommended
6483	Darunavir Lamotrigine 868	Darunavir			Lamotrigine			Potential for decreased anticonvulsant effects	Yellow: Adjust dosing	Adjust dosing to avoid decreased levels of lamotrigine	Monitor anticonvulsant level and adjust accordingly
6499	Darunavir MVC 884	Darunavir	600 mg with 100 mg ritonavir BID with etravirine 200 mg BID	Not reported	Maraviroc	150 mg BID	Cmax increase 77%, AUC increase 210%, Cmin increase 427%	Potential for increased maraviroc adverse effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of maraviroc	Use maraviroc 150 mg BID when combined with darunavir / ritonavir
6515	Darunavir Dabigatran 900	Darunavir			Dabigatran				Green: Administer standard doses	Administer standard doses	No dose adjustment if CrCL < 50 ml / min. Avoid concomitant use if CrCl > 50ml / min.
6531	Darunavir SOF/VEL 916	Darunavir	800 mg with 100 mg ritonavir once daily	Cmax decrease 10%, AUC decrease 8%, Cmin decrease 13%.	Sofosbuvir / Velpatasvir	400 / 100 mg	Sofosbuvir Cmax decrease 38%, AUC decrease 28%; Velpatasvir Cmax decrease 24%, AUC decrease 16%.		Green: Administer standard doses	Administer standard doses
6547	Darunavir Irinotecan 932	Darunavir			Irinotecan			Potential for increased risk of irinotecan adverse effects	Red: Avoid combination	Do not coadminister: Potential for increased irinotecan levels	Discontinue DRV / c at least 1wk prior to starting irinotecan. Do not coadminister unless there are no therapeutic alternatives
6563	Darunavir Naloxegol 948	Darunavir			Naloxegol			Potential for increased risk of precipitating opioid withdrawal	Red: Avoid combination	Do not coadminister: Potential for increased naloxegol levels	Contraindicated. Use alternative agents.
6579	Darunavir Ticagrelor 964	Darunavir			Ticagrelor			Potential for increased bleeding risk	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative antiplatelet agent
6595	Darunavir Vinblastine 980	Darunavir			Vinblastine			Potential for increased risk of vinblastine adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Consider temporarily withholding cobicistat-containing ARV regimen in patients who develop significant hematologic or gastrointestinal adverse effects. If ARV regimen must be withheld for a prolonged period of time, initate a revised regimen
6611	Darunavir Isavuconazole 996	Darunavir			Isavuconazole			Potential for increased risk of darunavir and isavuconazole adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Dose adjustment not established, monitor for increased DRV and / or antifungal adverse reactions
6627	Darunavir Nortiptyline 1012	Darunavir			Nortiptyline			Potential for increased risk of nortriptyline adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, initiate nortriptyline at low dose. Monitor for CNS and cardiovascular effects.
6643	Darunavir Timolol 1028	Darunavir			Timolol			Potential for increased risk of timolol adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, use caution and clinical monitoring is recommended
6484	Darunavir Omeprazole 869	Darunavir	600 mg with 100 mg ritonavir BID	No significant change	Omeprazole	40 mg x 1	Cmax decrease 34%, AUC decrease 42%	Potential decreased omeprazole efficacy	Yellow: Adjust dosing	Adjust dosing to avoid decreased levels of omeprazole	Consider using alternative agents. If coadministering, monitor for omeprazole efficacy. If no symptomatic relief, increase dose to no more than 40 mg once daily
6500	Darunavir Pravastatin 885	Darunavir	600 mg with 100 mg ritonavir BID	Not studied	Pravastatin	40 mg x 1	Cmax increase 63%, AUC increase 81%	Increased risk of pravastatin adverse effects (e.g. myopathy, rhabdomyolysis)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of pravastatin	Use lowest possible starting dose, monitor for toxicity and titrate.
6516	Darunavir Edoxaban 901	Darunavir			Edoxaban				Green: Administer standard doses	Administer standard doses	No dose adjustment if CrCL < 50 ml / min. Avoid concomitant use if CrCl > 50ml / min.
6532	Darunavir ETR 917	Darunavir	600 mg with 100 mg ritonavir BID		Etravirine	200 mg twice daily			Green: Administer standard doses	Administer standard doses
6548	Darunavir Ivabradine 933	Darunavir			Ivabradine			Potential for increased risk of ivabradine adverse effects (e.g. prolonged QT, cardiac arrythmias)	Red: Avoid combination	Do not coadminister: Potential for increased ivabradine levels	Use alternative agents
6564	Darunavir Perphenazine 949	Darunavir			Perphenazine			Potential for increased risk of perphenazine adverse effects	Red: Avoid combination	Do not coadminister: Potential for increased perphenazine levels	Contraindicated. Use alternative agents.
6580	Darunavir Vorapaxar 965	Darunavir			Vorapaxar			Potential for increased bleeding risk	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative antiplatelet agent
6596	Darunavir Vincristine 981	Darunavir			Vincristine			Potential for increased risk of vincristine adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Consider temporarily withholding cobicistat-containing ARV regimen in patients who develop significant hematologic or gastrointestinal adverse effects. If ARV regimen must be withheld for a prolonged period of time, initate a revised regimen
6612	Darunavir Posaconazole 997	Darunavir			Posaconazole			Potential for increased risk of darunavir and posaconazole adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Dose adjustment not established, monitor for increased DRV and / or antifungal adverse reactions
6628	Darunavir Trazodone 1013	Darunavir			Trazodone			Potential for increased risk of trazodone adverse effects (e.g. nausea, dizziness, hypotension, syncope)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, initiate trazodone at low dose. Monitor for CNS and cardiovascular effects.
6644	Darunavir CBZ 1029	Darunavir	600 mg with 100 mg ritonaivr BID	Darunavir: No significant change; Ritonavir cmax decreased 44%, AUC decreased 49%, Cmin decreased 56%	Carbamazepine	200 mg BID	Cmax increase 43%, AUC increase 45%, Cmin increase 54%	Increased carbamazepine effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Monitor anticonvulsant level and adjust accordingly. Consider carbamazepine dose reduction by 25-50%. Monitor antiviral efficacy
6485	Darunavir Valproic Acid 870	Darunavir			Valproic Acid			Potential for decreased anticonvulsant effects	Yellow: Adjust dosing	Adjust dosing to avoid decreased levels of valproic acid	Monitor anticonvulsant level and adjust accordingly
6501	Darunavir RFB 886	Darunavir	600 mg with 100 mg ritonavir BID	Darunavir Cmax increase 42%, AUC increase 57%, Cmin increase 75%; Ritonavir Cmax increase 68%, AUC increase 66%, Cmin increase 31%	Rifabutin	150 mg every other day	Rifabutin: Cmax decrease 28%, AUC decrease 7%, Cmin increase 64%; 25-O-desacetylrifabutin: Cmax increase 377%, AUC increase 881%, Cmin increase 2610%	Increased darunavir and rifabutin effects. Note that lower rifabutin exposure has been reported in HIV- infected patients as compared to healthy study participants.	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of rifabutin	Dose reduction of RFB by 75% of usual dose is recommended, such as rifabutin 150 mg every other day. Monitor for antimycobacterial activity and adverse events. Consider therapeutic drug monitoring.
6517	Darunavir Daclatasvir 902	Darunavir	600 mg with 100 mg ritonavir BID	No significant change	Daclatasvir	30 mg once daily	No significant change		Green: Administer standard doses	Administer standard doses	No dose adjustment necessary
6533	Darunavir Z-Pak 918	Darunavir			Azithromycin				Green: Administer standard doses	Administer standard doses
6549	Darunavir Alfuzosin 934	Darunavir			Alfuzosin			Potential for increased risk of alfuzosin adverse effects (e.g. hypotension)	Red: Avoid combination	Do not coadminister: Potential for increased levels of alfuzosin	Contraindicated. Use alternative agents.
6565	Darunavir Suvorexant 950	Darunavir			Suvorexant			Potential for increased risk of suvorexant adverse effects	Red: Avoid combination	Do not coadminister: Potential for increased suvorexant levels	Use alternative agents
6581	Darunavir Apixaban 966	Darunavir			Apixaban			Potential for increased bleeding risk	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination; use alternative anticoagulant	Dabigatran, betrixaban, edoxaban
6597	Darunavir Quetiapine 982	Darunavir			Quetiapine			Potential for increased risk of quetiapine adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Consider using alternative agents. If coadministering, reduce quetiapine dose to 1 / 6 of current dose and monitor for quetiapine adverse reactions
6613	Darunavir Itraconazole 998	Darunavir			Itraconazole			Potential for increased darunavir and itraconazole effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Dose adjustment not established; if co-administration needed, itraconazole dose should not exceed 200 mg daily
6629	Darunavir Zolpidem 1014	Darunavir			Zolpidem			Potential for increased risk of zolpidem adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, initiate zolpidem at low dose and titrate to effect
6645	Darunavir Dextromethrophan 1030	Darunavir	600 mg with 100 mg ritonavir BID	Not reported	Dextromethrophan	30 mg x 1	Cmax increase 127%, AUC increase 170%	Potential for increased dextromethorphan effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Monitor for dextromethorphan adverse effects
6486	Darunavir Atorvastatin 871	Darunavir	300 mg with 100 mg ritonavir BID	Not reported	Atorvastatin	40 mg once daily on days 1-4, then 10 mg once daily on days 4-7	Cmax decrease 44%, AUC decrease 15%, Cmin increase 81% (10 mg daily with darunavir / ritonavir compared to atorvastatin 40 mg daily alone)	Increased risk of atorvastatin adverse effects (e.g. myopathy, rhabdomyolysis)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of atorvastatin	Consider using alternative agents. If coadministering, consider low dose atorvastatin and doses < 20 mg. Monitor for myopathy
6502	Darunavir Risperidone 887	Darunavir			Risperidone			Potential for increased risk of risperidone adverse effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of risperidone	If coadministering, dose reduction may be necessary
6518	Darunavir Beclomethasone 903	Darunavir	600 mg with 100 mg ritonavir BID	Not reported	Beclomethasone	160 mcg inhaled BID	No change in AUC of active metabolite		Green: Administer standard doses	Administer standard doses	Use lowest possible dose and titrate to effect
6534	Darunavir Flecainide 919	Darunavir			Flecainide			Potential for increased risk of flecainide adverse effects	Red: Avoid combination	Do not coadminister: Increased levels of flecainide	Use alternative agents
6550	Darunavir Disopyramide 935	Darunavir			Disopyramide			Potential for increased risk of disopyramide adverse effects	Red: Avoid combination	Do not coadminister: Potential for increased levels of disopyramide	Use alternative agents
6566	Darunavir RIF 951	Darunavir			Rifampin			Potential loss of antiviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of darunavir	Contraindicated. Use alternative agents.	Rifabutin
6582	Darunavir Rivaroxaban 967	Darunavir			Rivaroxaban			Potential for increased bleeding risk	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination; use alternative anticoagulant	Dabigatran, betrixaban, edoxaban
6598	Darunavir Apixaban 983	Darunavir			Apixaban			Potential for increased bleeding risk	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Do not coadminister in patients who require apixaban 2.5 mg twice daily. In patients requiring apixaban 5 mg or 10 mg twice daily, reduce apixaban dose by 50%	Dabigatran
6614	Darunavir Ketoconazole 999	Darunavir	400 mg with 100 mg ritonavir BID		Ketoconazole	200 mg BID		Potential for increased darunavir and ketoconazole adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Dose adjustment not established; if co-administration needed, ketoconazole dose should not exceed 200 mg daily
6630	Darunavir Amlodipine 1015	Darunavir			Amlodipine			Potential for increased risk of amlodipine adverse effects (e.g. hypotension, bradycardia)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, monitor amlodipine adverse effects
6646	Darunavir Dexamethasone 1031	Darunavir			Dexamethasone		Not studied	Potential loss of antiviral efficiacy	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Monitor viral load if extended dexamethasone use. Consider alternative corticosteroid for long-term use.
6487	Darunavir Calcifediol 872	Darunavir			Calcifediol			Potential for increased risk of calcifediol adverse effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of calcifediol	If coadministering, dose adjustment may be required. Monitor serum 25-hydroxyvitamin D, intact PTH, and serum calcium concentrations
6503	Darunavir Rosuvastatin 888	Darunavir	600 mg with 100 mg ritonavir BID	No significant change	Rosuvastatin	10 mg once daily	Cmax increase 144%,AUC increase 48%	Increased risk of rosuvastatin adverse effects (e.g. myopathy, rhabdomyolysis); No change in lipid lowering ability within 35 day study period	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of rosuvastatin	Consider using alternative agents. If coadministering, consider initiating low dose rosuvastatin 5 mg daily
6519	Darunavir RPV 904	Darunavir	800 mg with 100 mg ritonavir once daily	No significant change	Rilpivirine	150 mg once daily	Cmax decrease 21%, AUC increase 130%, Cmin increase 178%	Potential for increased rilpivirine adverse effects	Green: Administer standard doses	Administer standard doses
6535	Darunavir EBR/GZR 920	Darunavir	800 mg once daily	No significant change	Elbasvir / Grazoprevir	50 / 100 mg once daily	Elbasvir AUC increase 66%; Grazoprevir AUC increase 7.5 fold	Potential for increased risk of ALT elevations due to a significant increase in grazoprevir plasma concentrations caused by OATP1B1 / 3 inhibition	Red: Avoid combination	Do not coadminister: Increased levels of grazoprevir	Contraindicated. Use alternative agents.
6551	Darunavir Dofetilide 936	Darunavir			Dofetilide			Potential for increased risk of dofetilide adverse effects	Red: Avoid combination	Do not coadminister: Potential for increased levels of dofetilide	Use alternative agents
6567	Darunavir CBZ 952	Darunavir			Carbamazepine			Potential loss of antiviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of darunavir	Contraindicated. Use alternative agents.
6583	Darunavir Fluticasone 968	Darunavir			Fluticasone			Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination or use alternative agents
6599	Darunavir Amiodarone 984	Darunavir			Amiodarone			Potential for increased risk of amiodarone adverse effects (e.g. hypotension, bradycardia, cardiac arrhythmias)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	If coadministering use with caution. Monitor for amiodarone toxicity. Consider ECG and amiodarone drug level monitoring.
6615	Darunavir Artemether / Lumefantrine 1000	Darunavir	600 mg with 100 mg ritonavir BID	No significant change	Artemether / Lumefantrine	80 / 480 mg	AUC decrease 16%; AUC increase 175%	Clinical significance unknown	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering monitor closely for anti- malarial efficacy and lumefantrine toxicity. Dose adjustment not established.
6631	Darunavir Nicardipine 1016	Darunavir			Nicardipine			Increased nicardipine effects (e.g. hypotension, heart block)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, monitor and adjust nicardipine as indicated
6647	Darunavir Betrixaban 1032	Darunavir			Betrixaban			Potential for increased bleeding risk	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	No dose adjustment if CrCL < 50 ml / min. Avoid concomitant use if CrCl > 50ml / min.
6488	Darunavir Cariprazine 873	Darunavir			Cariprazine			Potential for increased risk of cariprazine adverse effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of cariprazine	If starting cariprazine in a patient on a protease inhibitor, administer cariprazine 1.5 mg on Day 1 and Day 3, with no dose given on Day 2. From Day 4 onward, administer cariprazine 1.5 mg daily. Dose may be increased to a maximum of cariprazine 3 mg daily. If starting a protease inhibitor for a patient already taking cariprazine 3-6mg, reduce dose by half. For patients taking cariprazine 4.5 mg daily, reduced cariprazine dose to 1.5 - 3 mg daily. For patients taking cariprazine 1.5 mg daily, reduce to cariprazine 1.5 mg every other day. If PI is withdrawn, cariprazine dose may need to be increased.
6504	Darunavir Sildenafil 889	Darunavir	400 mg with 100 mg ritonavir BID	Not reported	Sildenafil	25 mg x 1	Cmax decrease 38% (compared to sildenafil 100 mg x 1 without darunavir / ritonavir)	Increased risk of sildenafil adverse effects (e.g. hypotension, priapism)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of sildenafil. (Do not coadminister for pulmonary hypertension)	For erectile dysfunction, do not exceed sildenafil 25 mg every 48 hours and monitor for adverse effects. Contraindicated if using sildenafil for pulmonary arterial hypertension.
6520	Darunavir Pitavastatin 905	Darunavir	800 mg with 100 mg ritonavir once daily	No significant change	Pitavastatin	4 mg once daily	AUC decreased 26%		Green: Administer standard doses	Administer standard doses
6536	Darunavir Propafenone 921	Darunavir			Propafenone			Potential for increased risk of propafenone adverse effects	Red: Avoid combination	Do not coadminister: Increased levels of propafenone	Use alternative agents
6552	Darunavir Ergotamine 937	Darunavir			Ergotamine			Potential for increased risk of ergotamine adverse effects (e.g. peripheral vasospasm, ischemia)	Red: Avoid combination	Do not coadminister: Potential for increased levels of ergotamine	Contraindicated. Use alternative agents.	5-HT agonists ("triptans")
6568	Darunavir St. John's Wort (Hypericum perforatum) 953	Darunavir			St. John's Wort			Potential loss of antiviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of darunavir	Contraindicated. Use alternative agents.
6584	Darunavir Budesonide 969	Darunavir			Budesonide			Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination or use alternative agents, particularly for long term use	Beclomethasone, prednisone, prednisolone
6600	Darunavir Dasatinib 985	Darunavir			Dasatinib			Potential for increased risk of dasatinib adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	If coadministering, decrease dose or adjust dosing interval as needed
6616	Darunavir Sirolimus 1001	Darunavir		Not studied	Sirolimus		Not studied (may increase rapamycin levels)	Increased risk of sirolimus adverse effects (supratherapeutic immunosuppression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, consider initiating lower immunosuppressant dose. Therapeutic drug monitoring is recommended. Consult with specialist as necessary.
6632	Darunavir Nifedipine 1017	Darunavir			Nifedipine			Increased nifedipine effects (e.g. hypotension, bradycardia)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, monitor and adjust nifedipine as indicated
6648	Darunavir Erythromycin 1033	Darunavir			Erythromycin			Potential for increased risk of antibacterial adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Use alternative agents	Azithromycin
6489	Darunavir Fesoterodine 874	Darunavir			Fesoterodine			Potential for increased risk of zolpidem adverse effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of fesoterodine	If coadministering, do not exceed fesoterodine 4 mg once daily
6505	Darunavir Tadalafil 890	Darunavir		Not studied	Tadalafil		Not studied (may increase tadalafil levels)	Increased risk of tadalafil adverse effects (e.g. hypotension, priapism)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of tadalafil	For erectile dysfunction, initiate tadalafil 5 mg dose and do not exceed 10 mg every 72 hours. Monitor adverse effects. For patients taking a protease inhibitor (stable > 7 days) requiring tadalafil for pulmonary arterial hypertension, initiate 20 mg once daily and increase to 40 mg once daily based on tolerability. Patients currently on tadalafil who require a PI should stop tadalafil ³24 hours before PI initiation, take the PI for 7 days, then resume tadalafil at 20 mg. Maximum recommended daily dose for treatment of BPH is 2.5 mg daily.
6521	Darunavir ATV 906	Darunavir	400 mg with 100 mg ritonavir BID	No significant change	Atazanavir	300 mg once daily	Cmax decrease 11%, AUC increase 8%, Cmin increase 52%		Green: Administer standard doses	Administer standard doses
6537	Darunavir Clopidogrel 922	Darunavir			Clopidogrel			Potential for increased bleeding risk	Red: Avoid combination	Do not coadminister: Potential for decreased clopidogrel levels	Use alternative agents
6553	Darunavir Lomitapide 938	Darunavir		Not studied	Lomitapide		Not studied	Potential for increased risk of lomitapide adverse effects	Red: Avoid combination	Do not coadminister: Potential for increased levels of lomitapide	Contraindicated. Use alternative agents.
6569	Darunavir Phenobarbital 954	Darunavir			Phenobarbital			Potential loss of antiviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of darunavir	Contraindicated. Use alternative agents.
6585	Darunavir Betamethasone 970	Darunavir			Betamethasone			Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination or use alternative agents, particularly for long term use	Beclomethasone, prednisone, prednisolone
6601	Darunavir Nilotinib 986	Darunavir			Nilotinib			Potential for increased risk of nilotinib adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	If coadministering, decrease dose or adjust dosing interval as needed
6617	Darunavir Tacrolimus 1002	Darunavir		Not studied	Tacrolimus		Not studied (may increase tacrolimus levels)	Potential for increased risk of tacrolimus adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, consider initiating lower immunosuppressant dose. Therapeutic drug monitoring is recommended. Consult with specialist as necessary.
6633	Darunavir Quinidine 1018	Darunavir			Quinidine			Potential for increased risk of quinidine adverse effects (e.g. cardiac arrhythmias, exacerbation of heart failure)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, monitor and adjust quinidine as indicated
6490	Darunavir Fluvastatin 875	Darunavir			Fluvastatin			Potential for increased risk of fluvastatin adverse effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of fluvastatin	Consider using alternative agents. If coadministering, initate lowest recommended dose and titrate while monitoring
6506	Darunavir Thioridazine 891	Darunavir			Thioridazine			Potential for increased risk of thioridazine adverse effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of thioridazine	If coadministering, dose reduction may be necessary
6522	Darunavir DTG 907	Darunavir	600 mg with 100 mg ritonavir BID	No significant change	Dolutegravir	30 mg once daily	Cmax decrease 11%, AUC decrease 22%, Cmin decrease 38%		Green: Administer standard doses	Administer standard doses
6538	Darunavir RPT 923	Darunavir			Rifapentine			Potential loss of antiviral efficacy	Red: Avoid combination	Do not coadminister: Potential for decreased darunavir levels	Use alternative agents
6554	Darunavir HMG-CoA Reductase Inhibitors 939	Darunavir		Not studied	Lovastatin		Not studied (may increase lovastatin levels)	Increased risk of lovastatin adverse effects (e.g. myopathy, rhabdomyolysis)	Red: Avoid combination	Do not coadminister: Potential for increased levels of lovastatin	Contraindicated. Use alternative agents.	Atorvastatin (low dose)
6570	Darunavir Phenytoin 955	Darunavir			Phenytoin			Potential loss of antiviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of darunavir	Contraindicated. Use alternative agents.
6586	Darunavir Ciclesonide 971	Darunavir			Ciclesonide			Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination or use alternative agents, particularly for long term use	Beclomethasone, prednisone, prednisolone
6602	Darunavir Tamsulosin 987	Darunavir			Tamsulosin			Potential for increased risk of tamsulosin adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	If coadministering, monitor for clinical toxicities
6618	Darunavir Amitriptyline 1003	Darunavir			Amitriptyline			Potential for increased risk of amitriptyline adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, initiate amitriptyline at low dose. Monitor for CNS and cardiovascular effects.
6634	Darunavir Felodipine 1019	Darunavir			Felodipine			Potential for increased risk of felodipine adverse effects (e.g. hypotension, bradycardia)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, monitor felodipine adverse effects
6651	Ritonavir ATV 1036	Ritonavir	100 mg daily on days 11-20	Not studied	Atazanavir	300 mg daily on days 1-20	Atazanavir AUC increased 238%; Cmax increased 86%; Cmin increased 1089%	Increased atazanavir effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of atazanavir	Dose atazanavir 300 mg once daily with ritonavir 100 mg daily
6667	Ritonavir Methadone 1052	Ritonavir	400 mg BID combined with 400 mg BID saquinavir		Methadone		S-methadone AUC decreased 25%; R-methadone AUC decreased 20%	Not clinically significant	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of methadone	If coadministering monitor for signs and symptoms of methadone withdrawal. Some patients may require an increased methadone dose
6683	Ritonavir Cetirizine 1068	Ritonavir	600 mg BID	Not studied	Cetirizine	10 mg daily	Cetirizine AUC increased 42%; half-life: increased 52%; clearance: decreased 29%; Cmax no significant change		Green: Administer standard doses	Administer standard doses
6699	Ritonavir Ethinyl estradiol / Norethindrone acetate 1084	Ritonavir	500 mg Q12H		Ethinyl estradiol / Norethindrone acetate	50 mcg x 2 doses	Ethinyl estradiol Cmax decreased 32%; AUC decreased 41%	Decreased oral contraceptive effectiveness	Red: Avoid combination	Do not coadminister: Reduced levels of ethinyl estradiol	Use alternative contraceptive method	Barrier devices; Condoms
6715	Ritonavir Meperidine 1100	Ritonavir	500 mg BID x 10 days		Meperidine	50 mg PO x 1 dose	Meperidine AUC decreased 67%; normeperidine AUC increased 47%	Increased normeperidine effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering monitor for pain control and adjust dose as indicated	Morphine
6652	Ritonavir Bosentan 1037	Ritonavir		Not studied	Bosentan		Not studied (may increase bosentan levels)	Possible increased bosentan effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of bosentan	Start low and titrate bosentan to effect. If patient has been on protease inhibitor (other than unboosted atazanavir) for more than 10 days, start bosentan at 62.5 mg daily or every other day. If patient is currently on bosentan and requires a PI (other than unboosted atazanavir), stop bosentan for at least 36 hours prior to initiating ART. Wait 10 days and then resume bosentan starting with 62.5 mg daily or every other day.
6668	Ritonavir Methadone 1053	Ritonavir	100 mg BID x 7 days		Methadone	Stable methadone dose	No significant effect		Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of methadone	If coadministering monitor for signs and symptoms of methadone withdrawal. Some patients may require an increased methadone dose
6684	Ritonavir Escitalopram 1069	Ritonavir	600 mg x 1 dose	No significant change	Escitalopram	20 mg x 1 dose	No significant change		Green: Administer standard doses	Administer standard doses
6700	Ritonavir RIF 1085	Ritonavir	500 mg Q12H x 20 days	Ritonavir AUC decreased 35%; Cmax decreased 25%	Rifampin	300 mg or 600 mg x 10 days		Decreased ritonavir effects	Red: Avoid combination	Do not coadminister: Reduced levels of ritonavir	Use alternative agents	Rifabutin
6716	Ritonavir Flecainide 1101	Ritonavir		Not studied	Flecainide		Not studied (may increase flecainide levels)	Increased flecainide effects (eg, cardiac arrhythmias)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering use with caution and monitor for toxicity. Consider therapeutic drug monitoring
6653	Ritonavir Clarithromycin 1038	Ritonavir	200 mg TID	AUC no significant change; Cmax increased 15%	Clarithromycin	500 mg BID	Clarithromycin AUC increased 77%; Cmax increased 31%; Cmin increased 182%	Increased clarithromycin effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of clarithromycin	Reduce clarithromycin dose by 50% in patients with CrCl 30-60 mL / min. Reduce clarithromycin dose by 75% in patients with CrCl <30 mL / min.
6669	Ritonavir Prednisolone 1054	Ritonavir	200 mg BID for 4 and 14 days		Prednisolone	20 mg x 1 dose	Prednisolone AUC increased 30%; clearance: decreased 23%	Potential increased prednisolone effects (adrenal insufficiency, Cushing's syndrome).	Green: Administer standard doses	Administer standard doses	Do not coadminister unless potential benefits of prednisone outweigh the risks of systemic corticosteroid adverse effects.
6685	Ritonavir Fluticasone 1070	Ritonavir			Fluticasone		Fluticasone AUC increased 350-fold; Cmax increased 25-fold	Decreased plasma cortisol concentrations (eg, Cushing's syndrome, adrenal suppression)	Red: Avoid combination	Do not coadminister: Increased levels of fluticasone	Avoid combination and use alternative agents
6701	Ritonavir Voriconazole 1086	Ritonavir	100 mg Q12H x 9 days	No significant change	Voriconazole	400 mg Q12H	Voriconazole AUC decreased 39%; Cmax decreased 24%	Decreased voriconazole effects	Red: Avoid combination	Do not coadminister: Reduced levels of voriconazole	Do not coadminister with ritonavir or other ritonavir-boosted protease inhibitors unless benefit outweighs risks. If coadministering consider therapeutic drug monitoring.	Consider use of non-ritonavir containing antiretroviral regimens
6717	Ritonavir Itraconazole 1102	Ritonavir		Increased ritonavir levels)	Itraconazole			Increased ritonavir effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, consider keeping doses of itraconazole < 200 mg daily
6654	Ritonavir Colchicine 1039	Ritonavir	100 mg BID x 5 days		Colchicine	0.6 mg x 1	Colchicine AUC increased 296%; Cmax increased 184%	Increased colchicine effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of colchicine	For treatment of gout, reduce colchicine dosage to 0.6 mg x 1 then 0.3 mg one hour later. Dose should not be repeated earlier than 3 days after. For gout prophylaxis, reduce colchicine dose to 0.3 mg daily if on 0.6 mg BID prior to PI therapy or reduce colchicine dose to 0.3 mg every other day if on 0.6 mg daily prior to PI therapy. For treatment of familial Mediterranean fever do not exceed colchicine 0.6 mg once daily or 0.3 mg BID. Do not coadminister in patients with hepatic or renal impairment.
6670	Ritonavir Amitriptyline 1055	Ritonavir		Not studied	Amitriptyline		Not studied (may increase amitriptyline levels)	Increased amitriptyline effects (eg, dry mouth, hypotension, confusion)	Green: Administer standard doses	Administer standard doses	Monitor and adjust amitriptyline as indicated
6686	Ritonavir Fluticasone 1071	Ritonavir	100 mg BID x 7 days		Fluticasone	200 mcg once daily x 7 d	Fluticasone Cmax increased 2572%; AUC increased 36697%	Increased fluticasone effects (eg, Cushing's syndrome, adrenal suppression)	Red: Avoid combination	Do not coadminister: Increased levels of fluticasone	Avoid combination and use alternative agents
6702	Ritonavir Voriconazole 1087	Ritonavir	400 mg Q12H x 9 days	No significant change	Voriconazole	400 mg Q12H	Voriconazole AUC decreased 83%; Cmax decreased 68%	Decreased voriconazole effects	Red: Avoid combination	Do not coadminister: Reduced levels of voriconazole	Do not coadminister with ritonavir or other ritonavir-boosted protease inhibitors unless benefit outweighs risks. If coadministering consider therapeutic drug monitoring.	Consider use of non-ritonavir containing antiretroviral regimens
6718	Ritonavir Theophylline 1103	Ritonavir	Days 1-5 none; day 6 300 mg Q12H; day 7 400 mg Q12H; days 8-15 500 mg Q12H		Theophylline	3 mg / kg Q8H	Theophylline AUC decreased 43%; Cmax decreased 32%; Cmin decreased 57%; half-life: decreased 57%	Decreased theophylline effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Monitor and adjust theophylline as clinically indicated
6655	Ritonavir Digoxin 1040	Ritonavir	200 mg BID x 15 days		Digoxin	0.4 mg x 1 dose	Digoxin AUC (0-8 hr): increased 29%; AUC (0-72 hr): increased 22%; clearance: decreased 30%; half-life: increased 43%	Increased digoxin effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of digoxin	Digoxin dose may need to be decreased. Monitor digoxin level and adjust digoxin dose based on clinical signs and drug levels.
6671	Ritonavir Desipramine 1056	Ritonavir		Not studied	Desipramine		Desipramine clearance: decreased 59%	Increased desipramine effects (eg, dry mouth, dizziness, urinary retention)	Green: Administer standard doses	Administer standard doses	Monitor and adjust desipramine as indicated
6687	Ritonavir Triazolam 1072	Ritonavir	200 mg BID x 2 days		Triazolam	0.125 mg x 1 dose	Triazolam AUC increased 1939%; half-life: increased 1267%; Cmax increased 87%	Increased triazolam effects (eg, increased confusion, sedation, respiratory depression)	Red: Avoid combination	Do not coadminister: Increased levels of triazolam	Use alternative agents	Lorazepam, Oxazepam, Temazepam, Trazodone
6703	Ritonavir CBZ 1088	Ritonavir	200 mg daily TID	Decreased ritonavir levels)	Carbamazepine	350 mg BID	Not studied (may increase carbamazepine levels)	Increased carbamazepine effects; decreased ritonavir effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative agents. If coadministering monitor carbamazepine levels and adjust as indicated. Monitor antiviral efficacy	Gabapentin Lamotrigine Tiagabine Topiramate
6719	Ritonavir Midazolam 1104	Ritonavir		Not studied	Midazolam		Not studied (may increase midazolam levels)	Increased midazolam effects (eg, increased sedation, confusion, respiratory depression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Parenteral midazolam can be used with caution when given as a single dose in a monitored situation for procedural sedation. Chronic midazolam administration (oral or intravenous) should be avoided.	Lorazepam
6656	Ritonavir Fentanyl 1041	Ritonavir	Day 1: 200 mg TID; Day 2: 300 mg TID; Day 3: 300 mg QAM		Fentanyl	5 mcg / kg	Fentanyl clearance decreased 67%	Increased fentanyl effects (eg, increased sedation, confusion, respiratory depression)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of fentanyl	Monitor closely, start with low dose and titrate to pain response as indicated
6672	Ritonavir Levothyroxine 1057	Ritonavir	600 mg BID		Levothyroxine	0.125 mg		Increased TSH levels (eg, Signs and symptoms of hypothyroidism)	Green: Administer standard doses	Administer standard doses	Monitor and increase levothyroxine dose as indicated
6688	Ritonavir Disulfiram 1073	Ritonavir		Not studied	Disulfiram		Oral solution contains alcohol	Disulfiram reaction (eg, headache, hypotension, flushing, vomiting)	Red: Avoid combination	Do not coadminister: potential toxicity	Do not coadminister with ritonavir solution
6704	Ritonavir Quinine 1089	Ritonavir	200 mg Q12 h x 9 days	Ritonavir AUC increased 21%; Cmax increased 15%	Quinine	600 mg x 1	Quinine AUC increased 341%; Cmax increased 284%	Increased quinine effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative agents. If combination must be used a potential four-fold reduction in quinine dosage may be needed
6657	Ritonavir MVC 1042	Ritonavir	100 mg BID		Maraviroc	100 mg BID	Maraviroc AUC increased 161%; Cmin increased 355%; Cmax increased 28%	Increased maraviroc effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of maraviroc	Reduce dose of maraviroc to 150 mg BID with strong CYP3A4 inhibitors
6673	Ritonavir Zolpidem 1058	Ritonavir	200 mg BID x 2 days		Zolpidem	5 mg x 1 dose	Zolpidem AUC increased 28%; Cmax increased 22%	Increased zolpidem effects (eg, increased sedation, confusion)	Green: Administer standard doses	Administer standard doses	Monitor for excess sedation
6689	Ritonavir Metronidazole 1074	Ritonavir	Oral solution (contains alcohol) and capsules	Not studied	Metronidazole		Not studied	Disulfiram-like reaction (eg, headache, hypotension, flushing, vomiting)	Red: Avoid combination	Do not coadminister: potential toxicity	Do not coadminister with ritonavir solution
6705	Ritonavir Phenytoin 1090	Ritonavir		Not studied	Phenytoin		Increased phenytoin levels)	Increased phenytoin effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative agents. Monitor phenytoin levels and adjust as indicated. Monitor virologic response.	Gabapentin Lamotrigine Tiagabine Topiramate
6658	Ritonavir RFB 1043	Ritonavir	300 mg on day 15; 400 mg on day 16; 500 mg on days 17-24		Rifabutin	150 mg daily x 24 days	Rifabutin AUC increased 400%; Cmax increased 250%	Increased rifabutin effects (eg, uveitis)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of rifabutin	Decrease rifabutin to 150 mg every other day or 300 mg 3 times / week
6674	Ritonavir Dabigatran 1059	Ritonavir		Not studied	Dabigatran		Not studied (may increase dabigatran levels)	Potential for increased risk of bleeding	Green: Administer standard doses	Administer standard doses	No dose adjustment if CrCL < 50 ml / min. Avoid concomitant use if CrCl > 50ml / min.
6690	Ritonavir Tinidazole 1075	Ritonavir	Oral solution (contains alcohol) and capsules	Not studied	Tinidazole		Not studied	Disulfiram-like reaction (eg, headache, hypotension, flushing, vomiting)	Red: Avoid combination	Do not coadminister: potential toxicity	Do not coadminister with ritonavir solution
6706	Ritonavir Rivaroxaban 1091	Ritonavir		Not studied	Rivaroxaban		Not studied (may increase rivaroxaban levels)	Potential for increased risk of bleeding	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative anticoagulant	Dabigatran
6659	Ritonavir Sildenafil 1044	Ritonavir	300 mg, 400 mg and 500 mg BID on days 2, 3 and 4-8		Sildenafil	100 mg x 1 dose	Sildenafil AUC increased 1000%; Cmax increased 290%; Tmax: delayed 3 hours	Increased sildenafil effects (eg, hypotension, priapism)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of sildenafil. (Do not coadminister for pulmonary hypertension)	For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension.
6675	Ritonavir EFV 1060	Ritonavir	Day 1: 300 mg Q12H; Day 2: 400mg Q12H; Days 3-10: 500 mg Q12H	Ritonavir AUC increased 18%	Efavirenz	600 mg daily	Efavirenz AUC increased 21%	Possible increased effects of both drugs	Green: Administer standard doses	Administer standard doses	No dose adjustment required for boosting doses of ritonavir
6691	Ritonavir Alfuzosin 1076	Ritonavir		Not studied	Alfuzosin		Not studied (may increase alfuzosin levels)		Red: Avoid combination	Do not coadminister: Potential for increased levels of alfuzosin	Use alternative agents
6707	Ritonavir Vorapaxar 1092	Ritonavir		Not studied	Vorapaxar		Not studied (may increase effects of vorapaxar	Potential for increased risk of bleeding	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative antiplatelet agent
6660	Ritonavir Tadalafil 1045	Ritonavir	200 mg BID		Tadalafil	20 mg x 1	Tadalafil AUC increased 124%	Increased tadalafil effects (eg, hypotension, priapism)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of tadalafil	For erectile dysfunction initiate tadalafil 5 mg dose and do not exceed 10 mg every 72 hours. Monitor adverse effects. For patients taking a protease inhibitor (stable > 7 days) requiring tadalafil for pulmonary arterial hypertension initiate 20 mg once daily and increase to 40 mg once daily based on tolerability. Patients currently on tadalafil who require a PI should stop tadalafil ³24 hours before PI initiation, take the PI for 7 days, then resume tadalafil at 20 mg. Maximum recommended daily dose for treatment of BPH is 2.5 mg daily.
6676	Ritonavir Beclomethasone 1061	Ritonavir	100 mg BID	Not studied	Beclomethasone	160 mcg inhaled BID	Beclomethasone-17-monopriopionate AUC increased 108%; Cmax increased 67%		Green: Administer standard doses	Administer standard doses	Use lowest possible dose and titrate to effect
6692	Ritonavir Amiodarone 1077	Ritonavir		Not studied	Amiodarone		Not studied (may increase amiodarone levels)	Increased amiodarone effects (eg, cardiac arrhythmias)	Red: Avoid combination	Do not coadminister: Potential for increased levels of amiodarone	Do not coadminister
6708	Ritonavir Ticagrelor 1093	Ritonavir		Not studied	Ticagrelor		Not studied (may increase ticagrelor levels)	Potential for increased risk of bleeding	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination and use alternative antiplatelet agent
6661	Ritonavir Tadalafil 1046	Ritonavir	500 mg or 600 mg BID		Tadalafil	20 mg x 1	Tadalafil AUC increased 32%, Cmax decreased 30%	Increased tadalafil effects (eg, hypotension, priapism)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of tadalafil	For erectile dysfunction initiate tadalafil 5 mg dose and do not exceed 10 mg every 72 hours. Monitor adverse effects. For patients taking a protease inhibitor (stable > 7 days) requiring tadalafil for pulmonary arterial hypertension initiate 20 mg once daily and increase to 40 mg once daily based on tolerability. Patients currently on tadalafil who require a PI should stop tadalafil ³24 hours before PI initiation, take the PI for 7 days, then resume tadalafil at 20 mg. Maximum recommended daily dose for treatment of BPH is 2.5 mg daily.
6677	Ritonavir Fluoxetine 1062	Ritonavir	600 mg x 1 dose days 1 and 10	AUC increased 19%; Cmax no significant change	Fluoxetine	30 mg Q12H		Increased ritonavir effects; Potential increased fluoxetine effects	Green: Administer standard doses	Administer standard doses
6693	Ritonavir ATV/c 1078	Ritonavir		Not studied	Atazanavir / Cobicistat		Not studied; Potential increased atazanavir levels)	Potential atazanavir-associated adverse effects (hyperbilirubinemia, GI upset, etc.)	Red: Avoid combination	Do not coadminister: Potential for increased levels of atazanavir	Do not coadminister ritonavir or ritonavir containing products with atazanavir / cobicistat
6709	Ritonavir Apixaban 1094	Ritonavir		Not studied	Apixaban		Not studied (may increase levels) of apixaban.	Potential for increased risk of bleeding	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Avoid combination; use alternative anticoagulant	Dabigatran
6662	Ritonavir Trazodone 1047	Ritonavir			Trazodone		Trazodone AUC increased 2.4-fold; Cmax increased 34%	Increased trazodone effects (eg, nausea, dizziness, hypotension, syncope)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of trazodone	Decrease trazodone dose or start low and titrate to effect
6678	Ritonavir Posaconazole 1063	Ritonavir	100 mg daily	Ritonavir AUC increased 80%; Cmax increased 49%	Posaconazole	400 mg BID		Potential increased ritonavir effects	Green: Administer standard doses	Administer standard doses
6694	Ritonavir Ergotamine 1079	Ritonavir		Not studied	Ergotamine		Not studied (may increase ergotamine levels)	Increased ergotamine effects (eg, ergotism)	Red: Avoid combination	Do not coadminister: Potential for increased levels of ergotamine	Contraindicated. Use alternative agents.	5-HT agonists ("triptans")
6710	Ritonavir Diazepam 1095	Ritonavir		Not studied	Diazepam		Increased diazepam levels	Increased diazepam effects (eg, increased sedation, confusion, respiratory depression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Use alternative agents	Lorazepam, Oxazepam, Temazepam
6663	Ritonavir Trazodone 1048	Ritonavir	200 mg BID for 2 days	Not studied	Trazodone	50 mg x 1 dose	Trazodone AUC increased 240%; Cmax increased 34%; half-life: increased 220%	Increased trazodone effects (eg, nausea, hypotension, syncope)	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of trazodone	Decrease trazodone dose or start low and titrate to effect
6679	Ritonavir TMP/SMX 1064	Ritonavir	500 mg Q12H x 12 days		Trimethoprim / Sulfamethoxazole	160 mg / 800 mg x 1 dose	Sulfamethoxazole AUC decreased 20%; trimethoprim AUC increased 20%		Green: Administer standard doses	Administer standard doses
6695	Ritonavir Pimozide 1080	Ritonavir		Not studied	Pimozide		Not studied (may increase pimozide levels)	Increased pimozide effects (eg, hypotension, cardiac arrhythmias)	Red: Avoid combination	Do not coadminister: Potential for increased levels of pimozide	Contraindicated. Use alternative agents.
6711	Ritonavir Alprazolam 1096	Ritonavir	200 mg BID		Alprazolam	1 mg x 1 dose	Alprazolam clearance: decreased 59%; half-life: increased 122%	Increased alprazolam effects (eg, increased sedation, confusion, respiratory depression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Avoid combination and use alternative agents	Lorazepam
6664	Ritonavir Vardenafil 1049	Ritonavir	600 mg BID		Vardenafil	5 mg daily	Vardenafil AUC increased 49-fold; Cmax increased 13-fold. T1 / 2 increased to 26 hours.	Increased tadalafil effects	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of vardenafil	Initiate (and do not exceed) vardenafil 2.5 mg every 72 hours and monitor for adverse effects
6680	Ritonavir RAL 1065	Ritonavir	100 mg BID x 16 days		Raltegravir	400 mg x 1	Raltegravir AUC decreased 16%; Cmax decreased 24%		Green: Administer standard doses	Administer standard doses
6696	Ritonavir Propafenone 1081	Ritonavir		Not studied	Propafenone		Not studied (may increase propafenone levels)	Increased propafenone effects (eg, cardiac arrhythmias)	Red: Avoid combination	Do not coadminister: Potential for increased levels of propafenone	Use alternative agents
6712	Ritonavir Alprazolam 1097	Ritonavir	500 mg BID x 10 days		Alprazolam	1 mg x 1	Alprazolam AUC no significant change; Cmax decreased 16%		Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Avoid combination and use alternative agents	Lorazepam
6649	Ritonavir ETR 1034	Ritonavir	600 mg BID		Etravirine		Etravirine AUC decreased 46%; Cmax decreased 32%		Yellow: Adjust dosing	Adjust dosing to avoid decreased levels of etravirine	For ritonavir boosting - refer to individual protease inhibitors for specific recommendation
6665	Ritonavir Warfarin 1050	Ritonavir	400 mg BID		Warfarin	12.5 mg daily	INR: decreased	Decreased warfarin effects (eg, decreased INR, increased risk of clotting)	Yellow: Adjust dosing	Adjust dosing to avoid increased or reduced levels of warfarin	If coadministering monitor INR and adjust warfarin as indicated. Monitor for signs and symptons of bleeding.
6681	Ritonavir Fluconazole 1066	Ritonavir	200 mg Q6H x 4 days	Cmax increased 14.5%; AUC increased 12%; Cmin increased 14%	Fluconazole	400 mg x 1 day, then 200 mg days 2-5			Green: Administer standard doses	Administer standard doses
6697	Ritonavir Quinidine 1082	Ritonavir		Not studied	Quinidine		Not studied (may increase quinidine levels)	Increased quinidine effects (eg, cardiac arrhythmias)	Red: Avoid combination	Do not coadminister: Potential for increased levels of quinidine	Use alternative agents
6713	Ritonavir Tacrolimus 1098	Ritonavir			Tacrolimus	4 mg BID		Increased tacrolimus effects (eg, bone marrow suppression)	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering consider initiating lower immunosuppressant dose to account for potential increased concentrations and monitor for toxicities. Therapeutic drug monitoring is recommended. Consult with specialist as necessary.
6650	Ritonavir Olanzapine 1035	Ritonavir	500 mg BID	Not studied	Olanzapine	10 mg daily	Olanzapine AUC decreased 53%; half-life: decreased 50%; clearance: increased 115%; Cmax decreased 40%	Decreased olanzapine effects	Yellow: Adjust dosing	Adjust dosing to avoid decreased levels of olanzapine	Monitor clinical improvement and adjust olanzapine as indicated
6666	Ritonavir Methadone 1051	Ritonavir	400 mg BID x 7 days		Methadone	90 mg daily x 2 years	Methadone AUC decreased	Decreased methadone effects (eg, methadone withdrawal)	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of methadone	If coadministering monitor for signs and symptoms of methadone withdrawal. Some patients may require an increased methadone dose
6682	Ritonavir Mefloquine 1067	Ritonavir	200 mg BID x 7 days	AUC decreased 31%; Cmax increased 36%; Cmin decreased 43%	Mefloquine	250 mg daily x 3 days, then once weekly for 3 weeks	No significant change		Green: Administer standard doses	Administer standard doses
6698	Ritonavir St. John's Wort (Hypericum perforatum) 1083	Ritonavir		Not studied (may decrease ritonavir levels)	St. John's Wort		Not studied	Decreased ritonavir effects	Red: Avoid combination	Do not coadminister: Potential for reduced levels of ritonavir	Contraindicated. Use alternative agents.
6714	Ritonavir Ketoconazole 1099	Ritonavir		Increased ritonavir levels)	Ketoconazole			Increased ritonavir effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering consider keeping doses of ketoconazole < 200 mg daily
5691	Bictegravir St. John's Wort (Hypericum perforatum) 76	Bictegravir			St. John's Wort			Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC and TAF	Contraindicated. Use alternative agents.
5692	Bictegravir CBZ 77	Bictegravir			Carbamazepine			Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC and TAF	Use alternative agents
5693	Bictegravir Oxcarbazepine 78	Bictegravir			Oxcarbazepine			Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC and TAF	Use alternative agents
5678	Bictegravir Calcium carbonate 63	Bictegravir	50 mg once daily	If administered simultaneously in the fasted state Cmax decreased 42%, AUC decreased 33%. If administered simultaneously in the fed state Cmax decreased 10%, AUC increased 3%	Calcium carbonate	1200 mg single dose	Not reported	Potential decrease in antiretroviral efficacy	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of bictegravir	Bictegravir should be administered simultaenously with calcium carbonate supplements, with food.
5694	Bictegravir Phenobarbital 79	Bictegravir			Phenobarbital			Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC and TAF	Use alternative agents
5679	Bictegravir Calcium carbonate 64	Bictegravir	50 mg single dose	If administered simultaneously in the fasted state Cmax decreased 42%, AUC decreased 33%. If administered simultaneously in the fed state Cmax decreased 10%, AUC increased 3%	Calcium carbonate	1200 mg single dose	Not reported	Potential decrease in antiretroviral efficacy	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of bictegravir	Bictegravir should be administered simultaenously with calcium carbonate supplements, with food.
5695	Bictegravir Phenytoin 80	Bictegravir			Phenytoin			Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC and TAF	Use alternative agents
5680	Bictegravir Iron 65	Bictegravir	50 mg single dose	If administered simultaneously in the fasted state Cmax decreased 71%, AUC decreased 63%. If administered simultaneously in the fed state Cmax decreased 25%, AUC decreased 16%	Ferrous fumarate	324 mg single dose	Not reported	Potential decrease in antiretroviral efficacy	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of bictegravir	Bictegravir should be administered simultaenously with iron supplements, with food. Monitor for virologic efficacy.
5696	Bictegravir RIF 81	Bictegravir	75 mg once daily	Cmax decreased 28%, AUC decreased 75%	Rifampin	600 mg once daily (fed state)	Not reported	Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Reduced levels of bictegravir	Contraindicated. Use alternative agents.
5681	Bictegravir Metformin 66	Bictegravir	50 mg once daily	Not reported	Metformin	500 mg BID	Cmax inccreased 28%, AUC increased 39%, Cmin increased 36%	Potential increase in metformin adverse effects (gastrointestinal)	Green: Administer standard doses	Administer standard doses
5697	Bictegravir RFB 82	Bictegravir	75 mg once daily	Cmax decreased 20%, AUC decreased 38%, Cmin decreased 56%	Rifabutin	300 mg once daily (fasted)	Not reported	Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Reduced levels of bictegravir	Use alternative agents
5682	Bictegravir Midazolam 67	Bictegravir	50 mg once daily	Not reported	Midazolam	2 mg single dose	Cmax increased 3%, AUC increased 15%	Potential for increased sedation	Green: Administer standard doses	Administer standard doses
5698	Bictegravir Voriconazole 83	Bictegravir	75mg single dose	Cmax increased 9%, AUC increased 61%	Voriconazole	300 mg BID (fasted state)	Not reported	Potentially increased bictegravir adverse effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Consider using alternative agents; if coadministering, monitor for bictegravir adverse effects
5683	Bictegravir EE/NGM 68	Bictegravir	75 mg once daily	Not reported	Ethinyl estradiol / Norgestimate	EE 0.025mg once daily with NGM 0.180 / 0.215 / 0.250mg once daily	Ethinyl estradiol Cmax inccreased 15%, AUC increased 4%, Cmin increased 5%. Norelgestromin Cmax increased 23%, AUC increased 8%, Cmin increased 10%. Norgestrel Cmax increase 15%, AUC increase 13%, Cmin increase 14%		Green: Administer standard doses	Administer standard doses
5699	Bictegravir Dexamethasone 84	Bictegravir			Dexamethasone			Potential decrease in bictegravir levels and antiretroviral efficacy after chronic administration	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, monitor for antiretroviral efficacy. If using long-term, consider using alternative corticosteroid or antiretroviral.
5684	Bictegravir LDV/SOF 69	Bictegravir	75 mg once daily	Cmax decreased 2%, Cmin increased 4%	Ledipasvir / Sofosbuvir	90 / 400 mg once daily	Ledipasvir Cmax decreased 15%, AUC decreased 13%. Sofosbuvir Cmax increased 11%, AUC increased 7%		Green: Administer standard doses	Administer standard doses
5700	Bictegravir Disopyramide 85	Bictegravir			Disopyramide			Potential increase in disopyramide effects	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	If coadministering, monitor for disopyramide adverse effects
5685	Bictegravir SOF/VEL/VOX 70	Bictegravir	50 mg once daily	Cmax decreased 2%, AUC increased 7%, Cmin increased 10%	Sofosbuvir / Velpatasvir / Voxilaprevir	400 / 100 / 100 + 100 voxilaprevir once daily (fed state)	Sofosbuvir Cmax increased 14%, AUC increased 9%. Velpatasvir Cmax decreased 4%, AUC decreased 4%, Cmin decreased 6%. Voxilaprevir Cmax decreased 10%, AUC decreased 9%, Cmin decreased 3%		Green: Administer standard doses	Administer standard doses
5686	Bictegravir Dofetilide 71	Bictegravir			Dofetilide			Potentially increased dofetilide exposure and cardiac arrhythmias	Red: Avoid combination	Do not coadminister: Potential for increased levels of dofetilide	Contraindicated. Use alternative agents.
5687	Bictegravir Enzalutamide 72	Bictegravir			Enzalutamide			Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC	Contraindicated. Use alternative agents.
5688	Bictegravir Primidone 73	Bictegravir			Primidone			Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC	Contraindicated. Use alternative agents.
5689	Bictegravir RPT 74	Bictegravir		Not studied	Rifapentine		Not studied	Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC	Use alternative agents
5690	Bictegravir Eslicarbazepine 75	Bictegravir			Eslicarbazepine			Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Potential for reduced levels of BIC and TAF	Contraindicated. Use alternative agents.
5707	Dolutegravir Calcium carbonate 92	Dolutegravir	50 mg single dose	Cmax decreased 37%, AUC decreased 39%, Cmin decreased 39% if taken together, fasting conditions. No significant change in dolutegravir AUC if taken 2 hours before calcium carbonate or if taken simultaneously with food.	Calcium carbonate	1200 mg	Not studied	Potential decrease in antiretroviral efficacy if taken without food	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of dolutegravir	Administer dolutegravir 2 hours before or 6 hours after calcium-containing supplements. Alternatively, administer dolutegravir simulatenously with calcium supplements and with food.
5723	Dolutegravir Omeprazole 108	Dolutegravir	50 mg single dose	No significant change	Omeprazole	40 mg once daily	Not studied		Green: Administer standard doses	Administer standard doses
5739	Dolutegravir CBZ 124	Dolutegravir	50 mg once daily	Cmax decreased 33%, AUC decreased 49%, Cmin decreased 73%	Carbamazepine	300 mg BID	Not studied	Potential decrease in antiretroviral efficacy	Red: Avoid combination	Do not coadminister: Reduced levels of dolutegravir	Use alternative agents. If this combination must be used in an INSTI-na•ve adult patient, adminster dolutegravir 50 mg twice daily. Do not use in cases of clinically suspected InSTI resistance. Monitor antiviral efficacy	Gabapentin, Lamotrigine, Levitiracetam, Tiagabine, Topiramate
5708	Dolutegravir Calcium carbonate 93	Dolutegravir	50 mg single dose	Cmax decreased 37%, AUC decreased 39%, Cmin decreased 39% if taken together, fasting conditions. No significant change in dolutegravir AUC if taken 2 hours before calcium carbonate or if taken simultaneously with food.	Calcium carbonate	1200 mg	Not studied	Potential decrease in antiretroviral efficacy if taken without food	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of dolutegravir	Administer dolutegravir 2 hours before or 6 hours after calcium-containing supplements. Alternatively, administer dolutegravir simulatenously with calcium supplements and with food.
5724	Dolutegravir ATV 109	Dolutegravir	30 mg once daily	Cmax increased 50%, AUC increased 91%, Cmin increased 180%	Atazanavir	400 mg once daily	Not studied		Green: Administer standard doses	Administer standard doses
5709	Dolutegravir Sucralfate 94	Dolutegravir		Not studied (may decreased dolutegravir levels)	Sucralfate		Not studied	Potential decrease in antiretroviral efficacy	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of dolutegravir	Administer dolutegravir 2 hours before or 6 hours after sucralfate
5725	Dolutegravir Prednisone 110	Dolutegravir	50 mg once daily	Cmax increased 6%, AUC increased 11%, Cmin increased 17%	Prednisone	60 mg daily with taper	Not studied		Green: Administer standard doses	Administer standard doses
5710	Dolutegravir Multivitamin 95	Dolutegravir	50 mg single dose	Cmax decreased 35%, AUC decreased 33%, Cmin decreased 32%	Multivitamin	One-A-Day given simultaneously with dolutegravir	Not studied	Potential decrease in antiretroviral efficacy	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of dolutegravir	Administer dolutegravir 2 hours before or 6 hours after taking medications containing polyvalent cations.
5726	Dolutegravir DRV/r 111	Dolutegravir	30 mg once daily	Cmax decreased 11%, AUC decreased 22%, Cmin decreased 38%	Darunavir	600 / 100 mg once daily	Not studied		Green: Administer standard doses	Administer standard doses
5711	Dolutegravir Iron 96	Dolutegravir	50 mg single dose	Cmax decreased 57%, AUC decreased 54%, Cmin decreased 56% when administered simultaneously with ferrous fumarate, fasting conditions. No significant change in dolutegravir Cmax or AUC if given simultaneously with ferrous fumarate, with food or if given 2 hours after ferrous fumarate.	Ferrous fumarate	324 mg	Not studied	Potential decrease in antiretroviral efficacy if given with iron.	Yellow: Adjust dosing	Adjust dosing to avoid reduced levels of dolutegravir	Administer dolutegravir 2 hours before or 6 hours after taking medications containing polyvalent cations. Alternatively, administer dolutegravir simulatenously with iron supplements and with food.
5727	Dolutegravir SOF/VEL 112	Dolutegravir	50 mg once daily	Not studied	Sofosbuvir / Velpatasvir	400 / 100 mg daily	Sofosbuvir Cmax decreased 12%, AUC decreased 8%. No significant change in sofosbuvir metabolite GS-331007. Velpatasvir Cmax decreased 6%, AUC decreased 9%, Cmin decreased 12%.		Green: Administer standard doses	Administer standard doses
5712	Dolutegravir RFB 97	Dolutegravir	50 mg once daily	Cmax increased 16%, AUC decreased 5%, Cmin decreased 30%	Rifabutin	300 mg once daily	Not studied		Green: Administer standard doses	Administer standard doses
5728	Dolutegravir INH 113	Dolutegravir	50 mg once daily	AUC decreased 46%, Cmin decreased 74%	Isoniazid	15 mg / kg + rifapentine 900 mg once weekly	INH AUC increased 67-92% in 2 / 4 subjects. Rifapentine no significant change.	Potential for increased adverse effects of isoniazid (flu-like symptoms, nausea, vomiting, and fever)	Red: Avoid combination	Do not coadminister: Increased levels of izoniazid and reduced levels of dolutegravir	Use alternative agents
5713	Dolutegravir RPV 98	Dolutegravir	50 mg once daily	Cmax increased 13%, AUC increased 12%, Cmin increased 22%	Rilpivirine	25 mg once daily	Cmax increased 10%, AUC increased 6%, Cmin increased 21%		Green: Administer standard doses	Administer standard doses
5729	Dolutegravir Dalfampridine 114	Dolutegravir		Not studied	Dalfampridine		Not studied	Potential for increased dalfampridine toxicity	Red: Avoid combination	Do not coadminister: Potential for increased levels of dalfampridine	Contraindicated. Use alternative agents.