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Updates to the Database of ARV Drug Interactions
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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 OneDrug TwoClinical EffectsMechanismsManagement
Source: McNicholl I. HIV InSite Database of Antiretroviral Drug Interactions. University of California San Francisco: Center for HIV Information; 2013.
DarunavirMaravirocIncreased maraviroc effectsInhibition of CYP450 3A4 by darunavir/ritonavirNo 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 effectsNo 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 effectsInduction of CYP450 3A4 by etravirineIncrease maraviroc to 600 mg BID when combined with etravirine
EtravirineTelaprevirNo dosage adjustment necessary
RaltegravirTelaprevirPossibly increased raltegravir effectsNo dosage adjustment necessary
RilpivirineBoceprevirPossibly increased rilpivirine effectsNo dosage adjustment necessary
RilpivirineTelaprevirNo dosage adjustment necessary

Drug Interactions with Elvitegravir/Cobicistat
Coadministered DrugClinical EffectsMechanismsManagement
Source: McNicholl I. HIV InSite Database of Antiretroviral Drug Interactions. University of California San Francisco: Center for HIV Information; 2013.
BuprenorphineDo not coadminister
CarbamazepinePotentially decreased elvitegravir/cobicistat effectsConsider alternative anticonvulsants
ClonazepamPotentially increased clonazepam effectsMore frequent clinical monitoring is recommended
DarunavirPotentially decreased elvitegravir effectsDo not coadminister, owing to lack of clinical data
MethadoneNo dosage adjustment necessary
OxcarbazepinePotentially decreased elvitegravir/cobicistat effectsConsider alternative anticonvulsants
PhenobarbitalPotentially decreased elvitegravir/cobicistat effectsConsider alternative anticonvulsants
PhenytoinPotentially decreased elvitegravir/cobicistat effectsConsider alternative anticonvulsants
WarfarinIncreased or decreased warfarin effectsMonitor INR closely when patient is first initiating elvitegravir/cobicistat

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