| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Lenacapavir Diltiazem | Yellow: Adjust dosing | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential increased risk of diltiazem adverse effects |
If coadministering, monitor for cardiac medication adverse effects (e.g. hypotension) |
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| Darunavir Diltiazem 1025 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of diltiazem adverse effects |
If coadministering, titrate to effect and monitor diltiazem adverse effects |
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| Atazanavir Diltiazem 760 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of diltiazem | Potential for increased diltiazem effects (eg, hypotension, heart block) |
No significant change |
180 mg daily on days 7-11 and 19-23 | Diltiazem AUC increased 125%, Cmax increased 198%, Cmin decreased 59% |
Reduce diltiazem dose by 50%. ECG monitoring is recommended. |
| Nevirapine Diltiazem 637 | Orange: Minimal data to guide interaction | minimal data to guide interaction: weigh risks and benefits of using this combination | Potential decreased dilitazem efficacy |
If coadministring, titrate dilitazem based on clinical response |
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| Etravirine Diltiazem 572 | Orange: Minimal data to guide interaction | minimal data to guide interaction: weigh risks and benefits of using this combination | Potential decreased dilitazem efficacy |
If coadministring, titrate dilitazem based on clinical response |
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| Efavirenz Diltiazem 391 | Green: Administer standard doses | Administer standard doses | Decreased diltiazem effects |
EFV AUC increased 11%, Cmax increased %16, Cmin increased 13% |
240 mg daily x 14 days | Monitor diltiazem efficacy and to titrate to clinical effect |
|
| Efavirenz Diltiazem 390 | Green: Administer standard doses | Administer standard doses | Decreased diltiazem effects |
No significant change |
240 mg daily x 21 days | Diltiazem AUC decreased 69%; Cmax decreased 60%; Cmin decreased 63% |
Monitor diltiazem efficacy and to titrate to clinical effect |
| Efavirenz Diltiazem 389 | Green: Administer standard doses | Administer standard doses | Decreased diltiazem effects |
No significant change |
240 mg daily x 21 days | Diltiazem AUC decreased 69%; Cmax decreased 60%; Cmin decreased 63% |
Monitor diltiazem efficacy and to titrate to clinical effect |
| Efavirenz Diltiazem 388 | Green: Administer standard doses | Administer standard doses | Decreased diltiazem effects |
No significant change |
240 mg daily x 21 days | Diltiazem AUC decreased 69%; Cmax decreased 60%; Cmin decreased 63% |
Monitor diltiazem efficacy and to titrate to clinical effect |
| Elvitegravir Diltiazem 258 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of diltiazem adverse effects |
If coadministering use with caution and monitor ECG |
