| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Darunavir Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 958 | Red: Avoid combination | Do not coadminister: Reduced levels of darunavir | Potential decreased anti-HCV and anti-HIV efficacy |
Darunavir Cmax decreased 8%; AUC decreased 24%; Cmin decreased 48% |
250 mg BID + 25 / 150 / 100 mg once daily | Dasabuvir Cmax increase 10%, AUC decrease 6%, Cmin increase 10%; Ombitasvir Cmax and AUC decrease 14%, Cmin decrease 13%; Paritaprevir Cmin increase 54%, AUC increase 29%, Cmin increase 30% |
Use alternative agents |
| Darunavir Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 957 | Red: Avoid combination | Do not coadminister: Reduced levels of darunavir | Potential decreased anti-HCV and anti-HIV efficacy |
Cmax decrease 21%, AUC increase 34%, Cmin decrease 46% |
250 mg BID + 25 / 150 / 100 mg once daily | Dasabuvir Cmax decrease 25%, AUC decrease 28%, Cmin decrease 35%; Ombitasvir Cmax, AUC, and Cmin decrease 13%; Paritaprevir Cmax decrease 30%, AUC decrease 19%, Cmin increase 59% |
Use alternative agents |
| Darunavir Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 956 | Red: Avoid combination | Do not coadminister: Reduced levels of darunavir | Potential decreased anti-HCV and anti-HIV efficacy |
Cmax decrease 13%, AUC decrease 20%, Cmin decrease 43% |
250 mg BID + 25 / 150 / 100 mg once daily | Dasabuvir Cmax decrease 16%, AUC decrease 27%; Cmin decrease 46%; Ombitasvir Cmax decrease 24%, AUC and Cmin decrease 27%; Paritaprevir Cmax decrease 30%, AUC decrease 41%, Cmin decrease 17% |
Use alternative agents |
| Atazanavir Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 847 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Do not coadminister |
||||
| Rilpivirine Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 662 | Red: Avoid combination | Do not coadminister: Increased levels of rilpivirine | Potential for QT interval prolongation with higher concentrations of RPV. |
RPV increased 155%; AUC increased 225%; Cmin increased 262% |
paritaprevir 150 mg with ritonavir 100 mg with ombitasvir 25 mg daily + dasabuvir 250 mg BID | Dasabuvir Cmax increased 18%; AUC increased 17%; Cmin increased 10%. Ombitasvir AUC increased 9%. Paritaprevir Cmin increased 30%, AUC increased 23%; Cmin decreased 5%. |
Use alternative agents |
| Nevirapine Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 604 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of dasabuvir, ombitasvir, and paritaprevir | Potential decrease in HCV agent efficacy |
Nevirapine AUC decreased 27% (at week 4); Nevirapine AUC no significant change (at week 10)Nevirapine AUC with rifampicin approximates nevirapine baseline without rifampicin at week 10. |
Not studied (may decrease paritaprevir levels) |
Use alternative agents |
|
| Nevirapine Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 603 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of anti-HCV agents | Potential decrease in anti-HCV efficacy |
Not studied (may decrease paritaprevir levels) |
Use alternative agents |
||
| Etravirine Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 538 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of anti-HCV agents | Potential decrease in anti-HCV efficacy |
Not studied |
Not studied (may decrease paritaprevir levels) |
Use alternative agents |
|
| Efavirenz Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 433 | Red: Avoid combination | Do not coadminister: Potential for reduced antiviral activity | Significant GI and neurologic adverse events occurred, increase ALT |
Not studied |
Not studied (may decrease paritaprevir levels) |
Contraindicated. Use alternative agents. |
|
| Raltegravir Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 316 | Green: Administer standard doses | Administer standard doses | Raltegravir AUC increased 134% |
paritaprevir 150 mg with ritonavir 100 mg with ombitasvir 25 mg daily + dasabuvir 250 mg BID | |||
| Elvitegravir Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 186 | Red: Avoid combination | Do not coadminister: Potential for increased levels of antivirals | Potential for increased AUC of HCV agents |
Use alternative agents |
|||
| Maraviroc Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 59 | Red: Avoid combination | Do not coadminister: Potential for increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Use alternative agents |
