Table 3.
Mechanism and Risks of the 10 Most Frequent DDIs Among the POPVIH65 Cohort (n = 9076) in 2016
| DNCIs, No. (%) | Mechanism of Interaction | Potential Risksa | |
|---|---|---|---|
| PI or boost/inhaled glucocorticoidsb | 739 (29) | Inhibition of CYP3A4 yielding to a rise of plasma concentration of inhaled glucocorticoids | Cushing syndrome, adrenal suppression, and other glucocorticoids toxicities |
| Atazanavir or rilpivirine/proton pump inhibitorsc | 676 (27) | Decrease of intestinal absorption of ARV yielding to a subtherapeutic concentration | Ineffective ARV therapy |
| PI or boost/lercanidipine | 285 (11) | Inhibition of CYP3A4 yielding to a rise of plasma concentration of comedications | Not documented (theoretically: hypotension and cardiac rhythm disorders) |
| PI or boost/alfuzosin | 233 (9) | Severe hypotension | |
| PI or boost/domperidone | 136 (5) | Cardiac arythmia like QT interval prolongation | |
| PI or boost/amiodarone | 82 (3) | Cardiac arythmia like QT interval prolongation | |
| PI or boost/simvastatin | 79 (3) | Rhabdomyolysis | |
| PI or boost/apixaban or rivaroxaban | 67 (3) | Bleeding | |
| PI or boost/piroxicam | 51 (2) | Serious respiratory depression and hematologic abnormalities | |
| Darunavir/injectable lidocaine | 38 (2) | Cardiac arythmia like QT interval prolongation | |
| Other combinations | 126 (6) | — | — |
Abbreviations: ARV, antiretroviral; boost, ritonavir or cobicistat; DDIs, drug-drug interactions; PI, protease inhibitor (boosted or not); QT, .
aPotential risks are defined from the Liverpool HIV drug interactions website.
bInhaled glucocorticoids include aerosols of fluticasone or budesonide and nasal sprays of mometasone or triamcinolone.
cProton pump inhibitors include rabeprazole, omeprazole, lansoprazole, pantoprazole, and esomeprazole.