Selected 3A4 Substrates/Rifampin
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When these two medicines are taken together, your body may process your HIV medicine more quickly.
What might happen:
Your blood levels of HIV medicine may decrease and reduce its beneficial effects.
What you should do about this interaction:
Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Invirase (saquinavir mesylate) US prescribing information. Roche Laboratories, Inc. February, 2012.
2.Agenerase (amprenavir) Capsules US prescribing information. GlaxoSmithKline May, 2005.
3.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company August, 2013.
4.Reyataz (atazanavir sulfate) Australian product information. Bristol-Myers Squibb Pharmaceuticals January 8, 2004.
5.Prezista (darunavir) US prescribing information. Tibotec Inc. November, 2013.
6.Lexiva (fosamprenavir calcium) US prescribing information. GlaxoSmithKline February, 2013.
7.Crixivan (indinavir sulfate) US prescribing information. Merck & Co., Inc. February, 2011.
8.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories January, 2013.
9.Viracept (nelfinavir mesylate) US prescribing information. Agouron Pharmaceuticals, Inc. May, 2013.
10.Aptivus (tipranavir) US prescribing information. Boehringer Ingelheim Pharmaceuticals, Inc. February, 2012.
11.Fortovase (saquinavir) US prescribing information. Roche Laboratories, Inc. December, 2004.
12.Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir) prescribing information. Gilead Sciences, Inc. October, 2013.
13.Centers for Disease Control and Prevention Division of Tuberculosis Elimination. Updated Guidelines for the Use of Rifamycins for the Treatment of Tuberculosis Among HIV-Infected Patients Taking Protease Inhibitors or Nonnucleoside Reverse Transcriptase Inhibitors. Available at http://www.cdc.gov/nchstp/tb/tb_hiv_drugs/PDF/tbhiv.pdf January 20, 2004.
14.Dear Healthcare Provider Letter. Subject: Important drug interaction warning for saquinavir. Roche Laboratories, Inc. February 9, 2005.
15.Dear Canadian Healthcare Professional letter: Subject: Drug-induced hepatitis with marked transaminase elevations in healthy volunteers receiving rifampin 600 mg once daily in combination with ritonavir 100 mg / saquinavir 1000 mg twice daily. (ritonavir boosted saquinavir) Hoffmann-La Roche Limited February 10, 2005.
16.Polk RE, Brophy DF, Israel DS, Patron R, Sadler BM, Chittick GE, Symonds WT, Lou Y, Kristoff D, Stein DS. Pharmacokinetic Interaction between amprenavir and rifabutin or rifampin in healthy males. Antimicrob Agents Chemother 2001 Feb;45(2):502-8.
17.Rifadin (rifampin) US prescribing information. Sanofi-Aventis U.S. LLC February, 2013.
18.Justesen US, Andersen AB, Klitgaard NA, Brosen K, Gerstoft J, Pedersen C. Pharmacokinetic interaction between rifampin and the combination of indinavir and low-dose ritonavir in HIV-infected patients. Clin Infect Dis 2004 Feb 1;38(3):426-9.
19.Jaruratanasirikul S, Sriwiriyajan S. Effect of indinavir on the pharmacokinetics of rifampicin in HIV-infected patients. J Pharm Pharmacol 2001 Mar;53(3):409-12.
20.la Porte CJ, Colbers EP, Bertz R, Voncken DS, Wikstrom K, Boeree MJ, Koopmans PP, Hekster YA, Burger DM. Pharmacokinetics of adjusted-dose lopinavir-ritonavir combined with rifampin in healthy volunteers. Antimicrob Agents Chemother 2004 May;48(5):1553-60.
21.Ribera E, Azuaje C, Lopez RM, Domingo P, Soriano A, Pou L, Sanchez P, Mallolas J, Sambea MA, Falco V, Ocana I, Lopez-Colomes JL, Gatell JM, Pahissa A. Once-daily regimen of saquinavir, ritonavir, didanosine, and lamivudine in HIV-infected patients with standard tuberculosis therapy (TBQD Study). J Acquir Immune Defic Syndr 2005 Nov 1;40(3):317-23.
22.Grub S, Bryson H, Goggin T, Ludin E, Jorga K. The interaction of saquinavir (soft gelatin capsule) with ketoconazole, erythromycin and rifampicin: comparison of the effect in healthy volunteers and in HIV-infected patients. Eur J Clin Pharmacol 2001 May;57(2):115-21.
23.Phansalkar S, Desai AA, Bell D, Yoshida E, Doole J, Czochanski M, Middleton B, Bates DW. High-priority drug-drug interactions for use in electronic health records. J Am Med Inform Assoc 2012 Sep-Oct; 19(5):735-43.