Current Infectious Disease Reports

, Volume 14, Issue 1, pp 67–82 | Cite as

Important Drug-Drug Interactions in HIV-Infected Persons on Antiretroviral Therapy: An Update on New Interactions Between HIV and Non-HIV Drugs

HIV/AIDS (RD MacArthur, Section Editor)

Abstract

Advances in antiretroviral therapy have turned HIV into a chronic, manageable disease. Patients often require treatment for co-morbid conditions as well as HIV, and consequently, pharmacokinetic interactions between antiretrovirals (ARVs) and other drug classes are an increasing concern. Protease inhibitors and non-nucleoside reverse transcriptase inhibitors are involved in the CYP450 or other transporter systems, and may be associated with higher risk of clinically significant drug interactions. One reverse transcriptase inhibitor, abacavir, has demonstrated weak inhibition of CYP3A4, 2D6 and 2C9 in vitro, but is not associated with any clinically significant interactions involving the CYP450 system. The integrase inhibitor raltegravir is not involved in the CYP450 system, and may be a suitable option to use when trying to minimize interactions with other drug classes. This review summarizes recently published data on clinically significant drug interactions between ARVs and other drug classes including antineoplastics, immunosuppressant transplant drugs, directly acting antivirals for hepatitis C, antifungals, antimalarials, corticosteroids, psychotropics, hormonal contraceptives, anticoagulants, drugs for pulmonary hypertension, and herbal products. In situations of suspected or potential interactions, close monitoring is warranted, and dose adjustments or substitutions may be required.

Keywords

Antiretrovirals Drug interactions Antineoplastics Immunosuppressants Boceprevir Telaprevir Voriconazole Posaconazole Anti-malarial agents Corticosteroids Quetiapine Olanzapine Oxycodone Buprenorphine Hormonal contraceptives Anticoagulants Bosentan Sildenafil Pulmonary arterial hypertension Echinacea purpurea 

Notes

Disclosure

A. Tseng has served on the ViiV Advisory Board and has received grants from Janssen, ViiV, and Merck, as well as honoraria and payment for development of educational presentations from Abbott, Merck, and ViiV. M. Foisy has received honoraria and/or educational grants from Abbott Laboratories, Gilead Sciences, and ViiV Healthcare.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Toronto General HospitalTorontoCanada
  2. 2.Northern Alberta HIV ProgramFaculty of Pharmacy and Pharmaceutical Sciences, Edmonton Clinic Health AcademyEdmontonCanada

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