| Updates to the Database of ARV Drug Interactions |  | | HIV Meds Updates Reference Table | | May 1, 2013 | | Ian R. McNicholl, PharmD, BCPS (Added Qualifications-Infectious Diseases), HIV InSite Pharmacy Editor | | Susa Coffey, MD, HIV InSite Medical Editor |  | |
The following table summarizes recent additions to the HIV InSite Database of Antiretroviral Drug Interactions. For a full description of the updates, including references to the studies from which the data were derived, go to the database, click on a specific drug name, and search for the interacting agent. Note: Interactions between elvitegravir/cobicistat and several other medications have been identified. These interactions are compiled as a separate table at the bottom of this page. New ARV Interactions (November 2012-April 2013)| Drug One | Drug Two | Clinical Effects | Mechanisms | Management |
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| Source: McNicholl I. HIV InSite Database of Antiretroviral Drug Interactions. University of California San Francisco: Center for HIV Information; 2013. | | Darunavir | Maraviroc | Increased maraviroc effects | Inhibition of CYP450 3A4 by darunavir/ritonavir | No dosage adjustment necessary; utilize maraviroc 150 mg BID when combined with darunavir/ritonavir | Etravirine
(200 mg BID with darunavir/ritonavir 600/100 mg BID)
| Maraviroc
(150 mg BID) | Increased maraviroc effects | | No dosage adjustment necessary; utilize maraviroc 150 mg BID when combined with etravirine AND darunavir/ritonavir | Etravirine
200 mg BID | Maraviroc
(300 mg BID) | Decreased maraviroc effects | Induction of CYP450 3A4 by etravirine | Increase maraviroc to 600 mg BID when combined with etravirine | | Etravirine | Telaprevir | | | No dosage adjustment necessary | | Raltegravir | Telaprevir | Possibly increased raltegravir effects | | No dosage adjustment necessary | | Rilpivirine | Boceprevir | Possibly increased rilpivirine effects | | No dosage adjustment necessary | | Rilpivirine | Telaprevir | | | No dosage adjustment necessary | Drug Interactions with Elvitegravir/Cobicistat| Coadministered Drug | Clinical Effects | Mechanisms | Management |
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| Source: McNicholl I. HIV InSite Database of Antiretroviral Drug Interactions. University of California San Francisco: Center for HIV Information; 2013. | | Buprenorphine | | | Do not coadminister | | Carbamazepine | Potentially decreased elvitegravir/cobicistat effects | | Consider alternative anticonvulsants | | Clonazepam | Potentially increased clonazepam effects | | More frequent clinical monitoring is recommended | | Darunavir | Potentially decreased elvitegravir effects | | Do not coadminister, owing to lack of clinical data | | Methadone | | | No dosage adjustment necessary | | Oxcarbazepine | Potentially decreased elvitegravir/cobicistat effects | | Consider alternative anticonvulsants | | Phenobarbital | Potentially decreased elvitegravir/cobicistat effects | | Consider alternative anticonvulsants | | Phenytoin | Potentially decreased elvitegravir/cobicistat effects | | Consider alternative anticonvulsants | | Warfarin | Increased or decreased warfarin effects | | Monitor INR closely when patient is first initiating elvitegravir/cobicistat | |
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