| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Lenacapavir Sirolimus | Yellow: Adjust dosing | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential increased risk of immunosuppressant adverse effects |
Initiate adjusted dose of immunosuppressant to account for increased concentration and follow up with therapeutic drug monitoring to refine dosing. Monitor for adverse effects of immunosuppressant. Consult with specialist as necessary. |
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| Darunavir Sirolimus 1001 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased risk of sirolimus adverse effects (supratherapeutic immunosuppression) |
Not studied |
Not studied (may increase rapamycin levels) |
If coadministering, consider initiating lower immunosuppressant dose. Therapeutic drug monitoring is recommended. Consult with specialist as necessary. |
|
| Efavirenz Sirolimus 510 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits when using this combination | decreased effects of immunosuppresant |
if co administiring, monitor immunosuppressant efficacy |
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| Elvitegravir Sirolimus 269 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased sirolimus adverse effects (increased immunosuppression) |
If coadministering, initiate lower dose of immunosuppressant, therapeutic drug monitoring is recommended, assess toxicity, consult with specialist, and adjust dose as necessary |
