| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Rilpivirine (IM) Phenobarbital | Red: Avoid combination | Do not coadminister: Potential for reduced levels of rilpivirine | Decreased rilpivirine effects |
Use alternative agents |
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| Lenacapavir Phenobarbital | Red: Avoid combination | Do not coadminister: reduced levels of lenacapavir | Potential loss of antiviral efficacy |
Use alternative agents |
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| Darunavir Phenobarbital 961 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential loss of antiviral efficacy, Potential for decreased phenobarbital effects |
Avoid combination and use alternative agents. If coadministering, monitor and adjust phenytoin levels as indicated and monitor viral load. |
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| Darunavir Phenobarbital 954 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of darunavir | Potential loss of antiviral efficacy |
Contraindicated. Use alternative agents. |
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| Atazanavir Phenobarbital 845 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential loss of antiretroviral efficacy |
Avoid combination or use alternative agents |
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| Atazanavir Phenobarbital 833 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of atazanavir | Potential loss of antiretroviral efficacy |
Contraindicated. Use alternative agents. |
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| Tenofovir alafenamide Phenobarbital 720 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of TAF | Potential decrease in antiretroviral efficacy |
Not studied |
Not studied |
Contraindicated. Use alternative agents. |
|
| Etravirine Phenobarbital 554 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of etravirine and phenobarbital | Potential decreased etravirine effects; potential decreased anticonvulsants effects |
Avoid combination and use alternative agents |
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| Efavirenz Phenobarbital 489 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Decreased efavirenz effects |
Not studied |
Avoid combination and use alternative agents. If coadministering, monitor phenobarbital levels and adjust as indicated |
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| Efavirenz Phenobarbital 488 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Decreased efavirenz effects |
Not studied (may decrease levels) |
Not studied |
Avoid combination and use alternative agents. If coadministering, monitor phenobarbital levels and adjust as indicated |
|
| Efavirenz Phenobarbital 487 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Decreased efavirenz effects |
Not studied (may decrease levels) |
Not studied |
Avoid combination and use alternative agents. If coadministering, monitor phenobarbital levels and adjust as indicated |
|
| Doravirine Phenobarbital 351 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of doravirine | Potential decrease in antiretroviral efficacy |
Contraindicated. Use alternative agents. If discontinuing phenobarbital, a minimum 4 week cessation period is recommended prior to initiating doravirine. |
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| Cabotegravir Phenobarbital 337 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of CAB | Potential decrease in antiretroviral efficacy |
Not studied |
Not studied |
Contraindicated. Use alternative agents. |
|
| Raltegravir Phenobarbital 319 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of raltegravir | Potential decrease in antiretroviral efficacy |
Use alternative agents |
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| Elvitegravir Phenobarbital 216 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of elvitegravir | Potential decrease in antiretroviral efficacy |
Contraindicated. Use alternative agents. |
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| Dolutegravir Phenobarbital 117 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of dolutegravir | Potential decrease in antiretroviral efficacy |
Not studied (may decreased dolutegravir levels) |
Not studied |
Avoid combination or use alternative agents |
|
| Bictegravir Phenobarbital 79 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of BIC and TAF | Potential decrease in antiretroviral efficacy |
Use alternative agents |
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| Maraviroc Phenobarbital 39 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Potential decrease in antiretroviral efficacy |
Increase maraviroc dose to 600 mg BID. If including MVC, ETR plus a strong CYP3A4 inhibitor in the regimen, reduce maraviroc dose to 150 mg BID |
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| Fostemsavir Phenobarbital 20 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of temsavir | Potential decrease in antiretroviral efficacy |
Contraindicated. Use alternative agents. |
