Dexamethasone
| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Rilpivirine (IM) Dexamethasone | Red: Avoid combination | Do not coadminister: Potential for reduced levels of rilpivirine | Decreased rilpivirine effects if dexamethasone is given as more than a single-dose treatment |
Use alternative agents if therapy requires more than a single dose treatment of dexamethasone. |
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| Lenacapavir Dexamethasone | Yellow: Adjust dosing | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression). |
If co-administering, initiate with the lowest starting dose and titrate to clinical effect. Do not use doses of dexamethasone > 16 mg. Monitor for dexamethasone-related adverse effects. |
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| Darunavir Dexamethasone 1031 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential loss of antiviral efficiacy |
Not studied |
Monitor viral load if extended dexamethasone use. Consider alternative corticosteroid for long-term use. |
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| Elvitegravir Dexamethasone 278 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential loss of antiviral efficacy |
Monitor viral load if extended dexamethasone use. Consider alternative corticosteroid for long-term use. |
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| Bictegravir Dexamethasone 84 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential decrease in bictegravir levels and antiretroviral efficacy after chronic administration |
If coadministering, monitor for antiretroviral efficacy. If using long-term, consider using alternative corticosteroid or antiretroviral. |

