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Drugs that May Interact with Protease Inhibitors via CYP3A4 Metabolism -- Table V

December 18, 1997

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

The following is a list of medications that may potentially interact with ritonavir therapy via cytochrome P450, specifically CYP3A4 isoenzyme metabolism. Clinical trials measuring the magnitude of these potential interactions have not been conducted. Additionally both saquinavir and indinavir are metabolized via CYP3A4. The extent of these interactions is unknown at this time. Therefore, it may be appropriate to use therapeutic drug concentration monitoring, and/or increased monitoring of therapeutic and adverse effects when concomitantly administering any of the following medications with protease inhibitors, especially for agents with narrow therapeutic margins. Dosage reductions may be required for those medications that are extensively metabolized by CYP3A4.

Please refer to Norvir™ product labeling information for further details regarding other potential drug interactions via CYP2D6, CYP2C9/19, glucuronidation and other pathways.

Drug Category Drugs that interact with
Protease Inhibitors via CYP3A4
Analgesics,
Narcotics
alfentanil (Alfenta)
fentanyl (Sublimase/Innovar)
Antiarrhythmics disopyramide (Rythmodan)
lidocaine (Xylocaine, others)
Anticoagulant R-warfarin (Coumadin)
Anticonvulsants carbamazepine (Tegretol)
clonazepam (Klonopin)
ethosuximide (Zarontin)
Antihistamine loratadine (Claritin)
Antidepressants, other nefazodone (Serzone)
setraline (Zoloft)
trazodone (Desyrel)
Antiemetics dronabinol (Marinol)
ondansertron (Zofran)
Antimycobacterial rifampin (Rifadin, others)
Antiparasitics quinine (various)
Calcium Channel Blockers amlodipine (Norvasc)
diltiazem (Cardizem, Diltiazem)
felodipine (Plendil)
isradipine (DynaCirc)
nicardipine (Cardene)
nifedipine (Adalat, Procardia)
nimodipine (Nimotop)
nisoldipine (Sular)
verapamil (Calan, Isoptin)
Cancer Chemotherapeutic Agents etoposide (VePesid)
paclitaxel (Taxol)
tamoxifen (Nolvadex, others)
vinblastine (Velban)
vincristine (Oncovin)
Corticosteriods dexamethasone (Decadron, others)
prednisone (various)
Hypolipidemics lovastatin (Mevacor)
pravastatin (Pravachol)
Immunosuppresants cyclosporine (Sandimmune, Neoral)
tacrolimus (Prograf)

Reference: Norvir™ Prescribing Information (March 1, 1996)

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A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!



  
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This article was provided by U.S. Food and Drug Administration. It is a part of the publication Protease Inhibitors Backgrounder. Visit the FDA's website to find out more about their activities and publications.
 
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