Label
Potential interactions
Color
Orange
Orange: Minimal data to guide interaction
| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Rilpivirine (IM) Erythromycin | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased rilpivirine concentrations |
Consider alternative agents. If coadministration is necessary, monitor for adverse effects |
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| Rilpivirine (IM) Clarithromycin | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased rilpivirine concentrations |
Consider alternative agents. If coadministration is necessary, monitor for adverse effects |
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| Rilpivirine (IM) Azithromycin | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased rilpivirine concentrations |
Consider alternative agents. If coadministration is necessary, monitor for adverse effects |
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| Rilpivirine (IM) Ketoconazole | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased rilpivirine concentrations |
If coadministering, use standard doses and consider monitoring for antifungal efficacy and QTc prolongation |
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| Rilpivirine (IM) Methadone | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for reduced methadone concentrations |
If coadministering, monitor for methadone efficacy |
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| Ritonavir Midazolam 1104 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased midazolam effects (eg, increased sedation, confusion, respiratory depression) |
Not studied |
Not studied (may increase midazolam levels) |
Parenteral midazolam can be used with caution when given as a single dose in a monitored situation for procedural sedation. Chronic midazolam administration (oral or intravenous) should be avoided. |
|
| Ritonavir Theophylline 1103 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Decreased theophylline effects |
3 mg / kg Q8H | Theophylline AUC decreased 43%; Cmax decreased 32%; Cmin decreased 57%; half-life: decreased 57% |
Monitor and adjust theophylline as clinically indicated |
|
| Ritonavir Itraconazole 1102 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased ritonavir effects |
Increased ritonavir levels) |
If coadministering, consider keeping doses of itraconazole < 200 mg daily |
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| Ritonavir Flecainide 1101 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased flecainide effects (eg, cardiac arrhythmias) |
Not studied |
Not studied (may increase flecainide levels) |
If coadministering use with caution and monitor for toxicity. Consider therapeutic drug monitoring |
|
| Ritonavir Meperidine 1100 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased normeperidine effects |
50 mg PO x 1 dose | Meperidine AUC decreased 67%; normeperidine AUC increased 47% |
If coadministering monitor for pain control and adjust dose as indicated |
|
| Ritonavir Ketoconazole 1099 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased ritonavir effects |
Increased ritonavir levels) |
If coadministering consider keeping doses of ketoconazole < 200 mg daily |
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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. |
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| Ritonavir Alprazolam 1097 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | 1 mg x 1 | Alprazolam AUC no significant change; Cmax decreased 16% |
Avoid combination and use alternative agents |
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| Ritonavir Alprazolam 1096 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased alprazolam effects (eg, increased sedation, confusion, respiratory depression) |
1 mg x 1 dose | Alprazolam clearance: decreased 59%; half-life: increased 122% |
Avoid combination and use alternative agents |
|
| Ritonavir Diazepam 1095 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Increased diazepam effects (eg, increased sedation, confusion, respiratory depression) |
Not studied |
Increased diazepam levels |
Use alternative agents |
|
| Ritonavir Apixaban 1094 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of bleeding |
Not studied |
Not studied (may increase levels) of apixaban. |
Avoid combination; use alternative anticoagulant |
|
| Ritonavir Ticagrelor 1093 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of bleeding |
Not studied |
Not studied (may increase ticagrelor levels) |
Avoid combination and use alternative antiplatelet agent |
|
| Ritonavir Vorapaxar 1092 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of bleeding |
Not studied |
Not studied (may increase effects of vorapaxar |
Avoid combination and use alternative antiplatelet agent |
|
| Ritonavir Rivaroxaban 1091 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of bleeding |
Not studied |
Not studied (may increase rivaroxaban levels) |
Avoid combination and use alternative anticoagulant |
|
| Ritonavir Phenytoin 1090 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Increased phenytoin effects |
Not studied |
Increased phenytoin levels) |
Avoid combination and use alternative agents. Monitor phenytoin levels and adjust as indicated. Monitor virologic response. |
|
| Ritonavir Quinine 1089 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Increased quinine effects |
Ritonavir AUC increased 21%; Cmax increased 15% |
600 mg x 1 | Quinine AUC increased 341%; Cmax increased 284% |
Avoid combination and use alternative agents. If combination must be used a potential four-fold reduction in quinine dosage may be needed |
| Ritonavir CBZ 1088 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Increased carbamazepine effects; decreased ritonavir effects |
Decreased ritonavir levels) |
350 mg BID | Not studied (may increase carbamazepine levels) |
Avoid combination and use alternative agents. If coadministering monitor carbamazepine levels and adjust as indicated. Monitor antiviral efficacy |
| Darunavir Erythromycin 1033 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of antibacterial adverse effects |
Use alternative agents |
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| Darunavir Betrixaban 1032 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased bleeding risk |
No dose adjustment if CrCL < 50 ml / min. Avoid concomitant use if CrCl > 50ml / min. |
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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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| Darunavir Dextromethrophan 1030 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased dextromethorphan effects |
Not reported |
30 mg x 1 | Cmax increase 127%, AUC increase 170% |
Monitor for dextromethorphan adverse effects |
| Darunavir CBZ 1029 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased carbamazepine effects |
Darunavir: No significant change; Ritonavir cmax decreased 44%, AUC decreased 49%, Cmin decreased 56% |
200 mg BID | Cmax increase 43%, AUC increase 45%, Cmin increase 54% |
Monitor anticonvulsant level and adjust accordingly. Consider carbamazepine dose reduction by 25-50%. Monitor antiviral efficacy |
| Darunavir Timolol 1028 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of timolol adverse effects |
If coadministering, use caution and clinical monitoring is recommended |
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| Darunavir Metoprolol 1027 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of metoprolol adverse effects |
If coadministering, use caution and clinical monitoring is recommended |
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| Darunavir Carvedilol 1026 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of carvedilol adverse effects |
If coadministering, use caution and clinical monitoring is recommended |
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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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| Darunavir Verapamil 1024 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of verapamil adverse effects |
If coadministering, monitor verapamil adverse effects |
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| Darunavir Lidocaine 1023 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of lidocaine adverse effects |
If coadministering use with caution and monitor for lidocaine toxicity. Consider therapeutic drug monitoring and ECG if used systemically. |
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| Darunavir Ziprasidone 1022 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of ziprasidone adverse effects |
If coadministering, monitor for adverse effects |
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| Darunavir Nefazodone 1021 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of nefazodone adverse effects |
If coadministering, monitor for adverse effects |
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| Darunavir Ethosuximide 1020 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of ethosuximide adverse effects |
If coadministering, monitor for adverse effects |
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| Darunavir Felodipine 1019 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of felodipine adverse effects (e.g. hypotension, bradycardia) |
If coadministering, monitor felodipine adverse effects |
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| Darunavir Quinidine 1018 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of quinidine adverse effects (e.g. cardiac arrhythmias, exacerbation of heart failure) |
If coadministering, monitor and adjust quinidine as indicated |
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| Darunavir Nifedipine 1017 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased nifedipine effects (e.g. hypotension, bradycardia) |
If coadministering, monitor and adjust nifedipine as indicated |
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| Darunavir Nicardipine 1016 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased nicardipine effects (e.g. hypotension, heart block) |
If coadministering, monitor and adjust nicardipine as indicated |
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| Darunavir Amlodipine 1015 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of amlodipine adverse effects (e.g. hypotension, bradycardia) |
If coadministering, monitor amlodipine adverse effects |
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| Darunavir Zolpidem 1014 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of zolpidem adverse effects |
If coadministering, initiate zolpidem at low dose and titrate to effect |
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| Darunavir Trazodone 1013 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of trazodone adverse effects (e.g. nausea, dizziness, hypotension, syncope) |
If coadministering, initiate trazodone at low dose. Monitor for CNS and cardiovascular effects. |
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| Darunavir Nortiptyline 1012 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of nortriptyline adverse effects |
If coadministering, initiate nortriptyline at low dose. Monitor for CNS and cardiovascular effects. |
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| Darunavir CsA 1011 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of cyclosporine adverse effects (supratherapeutic immunosuppression, renal toxicity) |
Not studied |
Not studied (may increase cyclosporine levels) |
If coadministering, initiate lower dose of immunosuppressant, monitor concentrations and toxicity, consult with specialist, and adjust dose as necessary |
|
| Darunavir Imipramine 1010 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of imipramine adverse effects |
If coadministering, initiate imipramine at low dose. Monitor for CNS and cardiovascular effects. |
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| Darunavir Estazolam 1009 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of estazolam adverse effects |
If coadministering, initiate estazolam at low dose and titrate to effect |
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| Darunavir Diazepam 1008 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of diazepam adverse effects |
If coadministering, initiate diazepam at low dose and titrate to effect |
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| Darunavir Desipramine 1007 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of desipramine adverse effects (e.g. nausea, dizziness, hypotension, syncope) |
If coadministering, initiate desipramine at low dose. Monitor for CNS and cardiovascular effects. |
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| Darunavir Buspirone 1006 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of busprione adverse effects |
If coadministering, initiate buspirone at low dose and titrate to effect |
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| Darunavir Terazosin 1005 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of terazosin adverse effects |
If coadministering, initiate at lowest dose and titrate while monitoring for clinical response / adverse effects |
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| Darunavir Doxazosin 1004 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of doxazosin adverse effects |
If coadministering, initiate at lowest dose and titrate while monitoring for clinical response / adverse effects |
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| Darunavir Amitriptyline 1003 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of amitriptyline adverse effects |
If coadministering, initiate amitriptyline at low dose. Monitor for CNS and cardiovascular effects. |
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| 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. |
|
| 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. |
|
| Darunavir Artemether / Lumefantrine 1000 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Clinical significance unknown |
No significant change |
80 / 480 mg | AUC decrease 16%; AUC increase 175% |
If coadministering monitor closely for anti- malarial efficacy and lumefantrine toxicity. Dose adjustment not established. |
| Darunavir Ketoconazole 999 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased darunavir and ketoconazole adverse effects |
200 mg BID | Dose adjustment not established; if co-administration needed, ketoconazole dose should not exceed 200 mg daily |
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| Darunavir Itraconazole 998 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased darunavir and itraconazole effects |
Dose adjustment not established; if co-administration needed, itraconazole dose should not exceed 200 mg daily |
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| Darunavir Posaconazole 997 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of darunavir and posaconazole adverse effects |
Dose adjustment not established, monitor for increased DRV and / or antifungal adverse reactions |
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| Darunavir Isavuconazole 996 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of darunavir and isavuconazole adverse effects |
Dose adjustment not established, monitor for increased DRV and / or antifungal adverse reactions |
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| Darunavir Drospirenone / Ethinyl estradiol 995 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of drospirenone adverse effects (hyperkalemia) or decreased contraceptive efficacy |
Clinical monitoring is recommended |
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| Darunavir Clonazepam 994 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of clonazepam adverse effects |
Clinical monitoring is recommended |
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| Darunavir EVG/c 993 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased or increased elvitegravir, cobicistat, and / or darunavir effects |
Cmin decreased 21% |
150 / 150 mg once daily | Elvitegravir AUC decrease 20%, Cmin decrease 52%; Cobicistat AUC decrease 15-20% |
Use alternative agents. One study supports clinical use of elvitegravir / cobicistat with darunavir 800 mg daily in treatment experienced patients. |
| Darunavir Salmeterol 992 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of salmeterol adverse effects |
Use alternative agents |
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| Darunavir Alprazolam 991 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of alprazolam adverse effects |
Use alternative agents |
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| Darunavir Rivaroxaban 990 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased bleeding risk |
Use alternative agents |
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| Darunavir Prasugrel 989 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased antiplatelet activity |
Use alternative agents |
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| Darunavir Midazolam 988 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of midazolam adverse effects (e.g. increased sedation, confusion, respiratory depression) |
Parenteral midazolam can be used with caution when given as a single dose in a monitored situation for procedural sedation; chronic midazolam administration (oral or intravenous) is contraindicated |
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| Darunavir Tamsulosin 987 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of tamsulosin adverse effects |
If coadministering, monitor for clinical toxicities |
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| Darunavir Nilotinib 986 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of nilotinib adverse effects |
If coadministering, decrease dose or adjust dosing interval as needed |
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| Darunavir Dasatinib 985 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of dasatinib adverse effects |
If coadministering, decrease dose or adjust dosing interval as needed |
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| Darunavir Amiodarone 984 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of amiodarone adverse effects (e.g. hypotension, bradycardia, cardiac arrhythmias) |
If coadministering use with caution. Monitor for amiodarone toxicity. Consider ECG and amiodarone drug level monitoring. |
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| Darunavir Apixaban 983 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased bleeding risk |
Do not coadminister in patients who require apixaban 2.5 mg twice daily. In patients requiring apixaban 5 mg or 10 mg twice daily, reduce apixaban dose by 50% |
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| Darunavir Quetiapine 982 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of quetiapine adverse effects |
Consider using alternative agents. If coadministering, reduce quetiapine dose to 1 / 6 of current dose and monitor for quetiapine adverse reactions |
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| Darunavir Vincristine 981 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of vincristine adverse effects |
Consider temporarily withholding cobicistat-containing ARV regimen in patients who develop significant hematologic or gastrointestinal adverse effects. If ARV regimen must be withheld for a prolonged period of time, initate a revised regimen |
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| Darunavir Vinblastine 980 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of vinblastine adverse effects |
Consider temporarily withholding cobicistat-containing ARV regimen in patients who develop significant hematologic or gastrointestinal adverse effects. If ARV regimen must be withheld for a prolonged period of time, initate a revised regimen |
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| Darunavir Oxcarbazepine 979 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential loss of antiviral efficacy |
Consider alternate anticonvulsants. If coadministering, use caution and clinical monitoring is recommended |
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| Darunavir Eslicarbazepine 978 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential loss of antiviral efficacy |
Consider alternate anticonvulsants. If coadministering, use caution and clinical monitoring is recommended |
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| Darunavir Tramadol 977 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of tramadol adverse effects |
Clinical monitoring is recommended. Dose reduction may be needed |
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| Darunavir Oxycodone 976 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of oxycodone adverse effects (e.g. respiratory depression) |
Clinical monitoring is recommended |
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| Darunavir Fentanyl 975 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of fentanyl adverse effects (e.g. respiratory depression) |
Clinical monitoring is recommended |
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| Darunavir Triamcinolone 974 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression) |
Avoid combination or use alternative agents, particularly for long term use |
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| Darunavir Mometasone 973 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression) |
Avoid combination or use alternative agents, particularly for long term use |
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| Darunavir Methylprednisolone 972 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression) |
Avoid combination or use alternative agents, particularly for long term use |
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| Darunavir Ciclesonide 971 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression) |
Avoid combination or use alternative agents, particularly for long term use |
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| Darunavir Betamethasone 970 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression) |
Avoid combination or use alternative agents, particularly for long term use |
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| Darunavir Budesonide 969 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression) |
Avoid combination or use alternative agents, particularly for long term use |
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| Darunavir Fluticasone 968 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for decreased plasma cortisol concentrations (e.g. Cushing's syndrome, adrenal suppression) |
Avoid combination or use alternative agents |
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| Darunavir Rivaroxaban 967 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased bleeding risk |
Avoid combination; use alternative anticoagulant |
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| Darunavir Apixaban 966 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased bleeding risk |
Avoid combination; use alternative anticoagulant |
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| Darunavir Vorapaxar 965 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased bleeding risk |
Avoid combination and use alternative antiplatelet agent |
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| Darunavir Ticagrelor 964 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased bleeding risk |
Avoid combination and use alternative antiplatelet agent |
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| Darunavir Dabigatran 963 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased bleeding risk |
Avoid combination and use alternative anticoagulant |
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| Darunavir Phenytoin 962 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential loss of antiviral efficacy, Potential for decreased phenytoin effects |
Avoid combination and use alternative agents. If coadministering, monitor and adjust phenytoin levels as indicated and monitor viral load. |
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| Darunavir Phenobarbital 961 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential loss of antiviral efficacy, Potential for decreased phenobarbital effects |
Avoid combination and use alternative agents. If coadministering, monitor and adjust phenytoin levels as indicated and monitor viral load. |
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| Darunavir Voriconazole 960 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential decreased voriconazole effects |
Avoid coadministering with boosted protease inhibitors unless benefit outweighs risks. If coadministering, consider therapeutic drug monitoring. |
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| Atazanavir Apixaban 865 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefitsÊof using this combination | Increased apixaban levels, Potential for increased risk of bleeding |
Consider using alternative agents |
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| Atazanavir Rivaroxaban 864 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased risk of bleeding |
Consider using alternative agents |
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| Atazanavir Voriconazole 863 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential decreased voriconazole antifungal effects |
200 mg PO Q12H | Voriconazole AUC decreased 39% when given with ritonavir 100 mg BID |
With unboosted atazanavir no dose adjustment necessary, monitor for toxicity. Do not coadminister with boosted protease inhibitors unless benefit outweighs risks. Consider therapeutic drug monitoring. |
|
| Atazanavir Fluticasone 862 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Decreased plasma cortisol concentrations (eg, Cushing's syndrome, adrenal suppression) |
Use with caution with atazanavir, use with atazanavir / ritonavir is not recommended unless the potential benefit outweighs the risk |
