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Database of Antiretroviral Drug Interactions

Interactions with Dabigatran and Antiretrovirals

Antiretroviral (ARV)Dose of ARVDose of DabigatranEffect on ARV LevelsEffect on Dabigatran LevelsPotential Clinical EffectsMechanism of InteractionManagement
Atazanavir727
(ATV)(Reyataz)
---Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Atazanavir/cobicistat755, 727
(others)(Evotaz)
--- Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Darunavir727
(DRV)(Prezista)
---Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Darunavir/cobicistat727
(Prezcobix)
---Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Elvitegravir/cobicistat701
(Genvoya, Stribild)
---Not studied; may increase dabigatran levelsPotential for increased risk of bleedingInhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Antiretroviral (ARV)Dose of ARVDose of DabigatranEffect on ARV LevelsEffect on Dabigatran LevelsPotential Clinical EffectsMechanism of InteractionManagement
Elvitegravir/cobicistat727
(Genvoya, Stribild)
---Not studied; may increase dabigatran levelsPotential for increased risk of bleedingInhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Elvitegravir/ritonavir-boosted protease inhibitor701
---Not studied; may increase dabigatran levelsPotential for increased risk of bleedingInhibition of dabigatran metabolism via CYP3A4

No adjustment necessary if CrCl > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Fosamprenavir727
(FPV)(Lexiva)
--- Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Lopinavir/ritonavir727
(LPV/r)(Kaletra)
---Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Ritonavir727
(RTV)(Norvir)
--- Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Saquinavir727
(SQV)(Fortovase, Invirase)
--- Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

Tipranavir727
(TPV)(Aptivus)
--- Not studied; may increase dabigatran levels Potential for increased risk of bleeding Inhibition of dabigatran metabolism via CYP3A4

No dose adjustment if CrCL > 50 ml/min. Avoid concomitant use if CrCl < 50ml/min.

"-" indicates that there are no data available
 701:Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf.
 727:Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf.
 755:Evotaz [package insert]. Princeton, NJ: Bristol-Myers Squibb Company, 2017.