Presentation Outline ICHP Annual Meeting September 13-15

RAL Drug Interactions
• Does not inhibit, induce, nor is RAL a substrate of CYP 450
enzymes: glucuronidation (UGT1A1)
• Rifamycins
– 40% reduction in RAL AUC; RAL dose increased to 800 mg
BID when administered with rifampin
– No dose adjustment with rifabutin
References
• Guidelines for the use of antiretroviral agents in HIV‐
1‐infected adults and adolescents. Department of
Health and Human Services. 1‐239. Available at:
http://www.aidsinfo.nih.gov
• Thompson, MA et al. IAS‐USA Guidelines. JAMA
2012;308:387‐402.
• http://www.hiv‐druginteractions.org
Efavirenz Drug Interactions
• Hepatic enzyme induction
‐ Methadone
‐ Calcium channel blockers
‐ St Statins ti (t (atorvastatin, tti simvastatin, i t ti pravastatin) tti)
‐ Itraconazole, voriconazole ( 400mg bid, EFV 300 mg qd)
‐ Rifabutin (increase dose to 450 mg qd)
‐ Warfarin (monitor INR closely)
‐ Erectile Dysfunction drugs ( AUC)
8/30/2012
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