| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Lenacapavir Tacrolimus | 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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| Ritonavir Tacrolimus 1098 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased tacrolimus effects (eg, bone marrow suppression) |
4 mg BID | If coadministering consider initiating lower immunosuppressant dose to account for potential increased concentrations and monitor for toxicities. Therapeutic drug monitoring is recommended. Consult with specialist as necessary. |
||
| Darunavir Tacrolimus 1002 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of tacrolimus adverse effects |
Not studied |
Not studied (may increase tacrolimus levels) |
If coadministering, consider initiating lower immunosuppressant dose. Therapeutic drug monitoring is recommended. Consult with specialist as necessary. |
|
| Efavirenz Tacrolimus 511 | 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 Tacrolimus 270 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased tacrolimus 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 |
