TABLE 10.
Drug-drug interactions among antiretroviral agents, and telaprevir and boceprevir
| Antiretroviral agent | Boceprevir | Telaprevir |
|---|---|---|
| Non-nucleoside reverse transcriptase inhibitors | ||
| Efavirenz | 44% ↓ Cmin, 19% ↓ AUC of boceprevir (183). Avoid combination (126) | 47% ↓ Cmin of telaprevir (214); consider ↑ telaprevir dose to 1125 mg every 8 h with efavirenz (172) |
| Etravirine | 29% ↓ Cmin, 23% ↓ AUC of etravirine. Clinical relevance unclear (175) | No clinically significant changes in either drug. No dose adjustment required (173) |
| Rilpivirine | ↑ 39% AUC, ↑ 15% Cmax, ↑ 10% Cmin of rilpivirine, not considered clinically significant. No dose adjustment required (176) | ↑ 78% AUC, ↑ 49% Cmax, ↑ 93% Cmin of rilpivirine, not considered clinically significant. No dose adjustment required (173) |
| Protease inhibitors | ||
| Atazanavir/ritonavir | 49% ↓ Ctrough, 35% ↓ AUC of atazanavir (170). Avoid combination | 85% ↑ Cmin of atazanavir (172). Combination may be used |
| Darunavir/ritonavir | 59% ↓ Ctrough, 44% ↓ AUC of darunavir and 32% ↓ boceprevir (170). Avoid combination | 40% ↓ AUC and 42% ↓ Cmin of darunavir, 35% ↓ AUC and 32% ↓ Cmin of telaprevir (172). Avoid combination (169) |
| Fosamprenavir/ritonavir | No data | 47% ↓ AUC and 56% ↓ Cmin of amprenavir, 32% ↓ AUC and 30% ↓ Cmin of telaprevir (172). Avoid combination (169) |
| Lopinavir/ritonavir | 43% ↓ Ctrough, 34% ↓ AUC of lopinavir and 45% ↓ boceprevir (170). Avoid combination | 6% ↑ AUC and 14% ↑ Cmin of lopinavir, 54% ↓ AUC and 52% ↓ Cmin of telaprevir (172). Avoid combination (169) |
| Integrase inhibitors | ||
| Raltegravir | No clinically significant changes in either drug. No dose adjustment required (177) | No clinically significant changes in either drug. No dose adjustment required (178) |
| Reverse transcriptase inhibitors | ||
| Tenofovir | No clinically significant changes in either drug. No dose adjustment required (183) | No clinically significant changes in either drug. No dose adjustment required (184) |
↑ Increase; ↓ Decrease; AUC Area under the curve; Cmax Maximum plasma concentration; Cmin Minimum plasma concentration occuring during the dosing interval; Ctrough Minimum plasma concentration immediately before the next dose