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Database of Antiretroviral Drug Interactions

Interactions with Rifapentine and Antiretrovirals

Antiretroviral (ARV)Dose of ARVDose of RifapentineEffect on ARV LevelsEffect on Rifapentine LevelsPotential Clinical EffectsMechanism of InteractionManagement
Dolutegravir691
(Tivicay)
--Not studied; may decrease dolutegravir levels-Potentially decreased dolutegravir effectiveness-

Contraindicated - do not coadminister

Efavirenz681
(EFV)(Sustiva)
600 mg QD900 mg Q weekEfavirenz AUC: decreased 14%; Cmin: decreased 15%---

No dose adjustment necessary

Elvitegravir/cobicistat
(Genvoya, Stribild)
-- Expected significant decrease in elvitegravir and cobicistat levels- Potential loss of antiretroviral efficacy-

Do not coadminister

Elvitegravir/ritonavir-boosted protease inhibitor
-- Expected significant decrease in elvitegravir and cobicistat levels- Potential loss of antiretroviral efficacy-

Do not coadminister

Indinavir335, 336
(IDV)(Crixivan)
800 mg TID x 14 days600 mg twice a week x 14 daysIndinavir AUC: decreased 70%; Cmax: decreased 55%No significant changeDecreased indinavir effectsInduction of CYP450 3A4 by rifapentine

Dosage adjustment not established

Alternative Agents:
Rifabutin

Nelfinavir336
(NFV)(Viracept)
- - Not studied; may decrease nelfinavir levels- Decreased nelfinavir effectsInduction of CYP450 3A4 by rifapentine

Do not coadminister

Alternative Agents:
Rifabutin

Raltegravir589
(RAL)(Isentress)
400 mg BID900 mg PO once weeklyRaltegravir AUC: increased 73%; Cmax: increased 89%; Cmin: decreased 44%---

Do not coadminister

Raltegravir693
(RAL)(Isentress)
400 mg BID900 mg once weekly for 3 weeks or 600 mg once daily for 10 scheduled doses (days 1, 4–8 and 11–14)When given with rifapentine once weekly for 3 weeks raltegravir AUC increased 79%, Cmax increased 89% and Cmin decreased 12%. When given with rifapentine for 10 daily doses, Cmin decreased 41% - Potential for increased raltegravir adverse effects if given with rifapentine once weekly; potential for decreased raltegravir effectiveness if rifapentine co-administered daily-

Avoid co-administration

"-" indicates that there are no data available
 335:Temple ME, Nahata MC. Rifapentine: its role in the treatment of tuberculosis. Ann Pharmacother. 1999;33:1203-10.
 336:Prifitin [package insert]. Kansas City, MO: Hoechst Marion Roussel, Inc,; 1998.
 589:Weiner M, Peloquin C, Engle M, et al. The pharmacokinetic interaction between raltegravir and rifapentine in healthy volunteers [paper #615]. 19th Conference on Retroviruses and Opportunistic Infections, March 5-8, 2012. Seattle, WA.
 681:Farenc C, Doroumian S, Cantalloube C, et al. Rifapentine once-weekly dosing effect on efavirenz, emtricitabine and tenofovir pharmacokinetics [poster P-H1]. Conference on Retroviruses and Opportunistic Infections; 2014 March 3-6; Boston, Massachusetts.
 691:Tivicay [package insert]. Research Triangle Park, NC: Viiv Healthcare; August 2015
 693:Weiner M, et. al. Pharmacokinetic interaction of rifapentine and raltegravir in healthy volunteers. J. Antimicrob. Chemother. (2014) 69 (4): 1079-1085