Infectious Diseases II
Agent
Antiretroviral
Interactions
Stress ulcer prophylaxis
(proton pump inhibitors,
histamine-2 receptor
antagonists)
Rilpivirine: Contraindicated with proton
pump inhibitors
Atazanavir: Relatively contraindicated
with proton pump inhibitors (administer
no more than the equivalent of
omeprazole 20 mg daily, and separate
administration by at least 12 hr)
Decrease in antiretroviral concentrations
Triazole antifungals:
Voriconazole,
posaconazole,
itraconazole,
isavuconazole
Protease inhibitors
Nonnucleoside reverse transcriptase
inhibitors
Increase in antiretroviral concentration
Decrease in antifungal concentrations
Antibacterials:
Rifampin
Clarithromycin
Metronidazole
Protease inhibitors
Nonnucleoside reverse transcriptase
inhibitors
Protease inhibitors
Nonnucleoside reverse transcriptase
inhibitors
Fosamprenavir, lopinavir, ritonavir
Decrease in antiretroviral concentration
Increase in clarithromycin concentration
Disulfiram reaction
Antiarrhythmics:
Amiodarone
Flecainide,
propafenone, quinidine
Diltiazem
Indinavir, ritonavir, tipranavir
Lopinavir, ritonavir, tipranavir
Atazanavir, fosamprenavir
Increased antiarrhythmic concentrations
Statins
Protease inhibitors
Nonnucleoside reverse transcriptase
inhibitors
Increase concentrations of statins β in
decreasing order of interaction potential
(lovastatin, simvastatin, rosuvastatin,
atorvastatin, pravastatin)
Anticonvulsants:
Carbamazepine,
phenobarbital, phenytoin
Protease inhibitors
Nonnucleoside reverse transcriptase
inhibitors
Decrease in antiretroviral concentrations
Increase or decrease in anticonvulsant
concentrations
Midazolam
Protease inhibitors
Nonnucleoside reverse transcriptase
inhibitors
Cobicistat/elvitegravir
Increase in midazolam concentration
Methadone
Nonnucleoside reverse transcriptase
inhibitors; fosamprenavir, ritonavir,
lopinavir, nelfinavir, didanosine,
saquinavir
Decrease in methadone concentration
(potentially leading to opioid
withdrawal)