| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Ritonavir Itraconazole 1102 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased ritonavir effects |
Increased ritonavir levels) |
If coadministering, consider keeping doses of itraconazole < 200 mg daily |
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| Darunavir Itraconazole 998 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased darunavir and itraconazole effects |
Dose adjustment not established; if co-administration needed, itraconazole dose should not exceed 200 mg daily |
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| Atazanavir Itraconazole 762 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of itraconazole | Unless guided by therapeutic drug monitoring, limit doses of itraconazole to less than 200 mg daily when used with atazanavir / cobicistat. |
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| Nevirapine Itraconazole 631 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Decreased itraconazole effects and possible NVP concentrati |
Itraconazole AUC decreased 61% |
Avoid combination and use alternative agents |
||
| Etravirine Itraconazole 563 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Decreased itraconazole effects |
Not studied (may increase etravirine levels) |
Not studied (may decrease itraconazole levels) |
If coadministering, dose adjustment not established. Monitor itraconazole levels and etravirine toxicity. |
|
| Efavirenz Itraconazole 478 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Decreased itraconazole effects |
200 mg Q12H x 28 days | Itraconazole AUC decreased 39%; Cmax decreased 37%; Cmin decreased 44%; Hydroxyitraconazole AUC decreased 37%; Cmax decreased 35%; Cmin decreased 43% |
Avoid combination and use alternative agents |
|
| Efavirenz Itraconazole 477 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Decreased itraconazole effects |
200 mg Q12H x 28 days | Itraconazole AUC decreased 39%; Cmax decreased 37%; Cmin decreased 44%; Hydroxyitraconazole AUC decreased 37%; Cmax decreased 35%; Cmin decreased 43% |
Avoid combination and use alternative agents |
|
| Efavirenz Itraconazole 476 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Decreased itraconazole effects |
No significant change |
200 mg Q12H x 28 days | Itraconazole AUC decreased 39%; Cmax decreased 37%; Cmin decreased 44%; Hydroxyitraconazole AUC decreased 37%; Cmax decreased 35%; Cmin decreased 43% |
Avoid combination and use alternative agents |
| Elvitegravir Itraconazole 276 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased adverse effects from both elvitegravir and itraconazole |
Monitor itraconazole concentrations. If coadministering itraconazole dose should not exceed 200 mg daily unless guided by concentrations. |
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| Maraviroc Itraconazole 51 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Reduce maraviroc dose to 150 mg BID |
