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Drug Interactions between AccessPak for HIV PEP Expanded with Viracept and alfuzosin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

nelfinavir alfuzosin

Applies to: AccessPak for HIV PEP Expanded with Viracept (emtricitabine / nelfinavir / tenofovir) and alfuzosin

CONTRAINDICATED: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of alfuzosin, which is primarily metabolized by the isoenzyme. Severe hypotension and priapism may occur. In pharmacokinetic studies, repeated oral administration of 400 mg/day of ketoconazole, a potent CYP450 3A4 inhibitor, increased alfuzosin peak plasma concentration (Cmax) and systemic exposure (AUC) by 2.3- and 3.2-fold, respectively, following a single 10 mg dose. Repeated oral administration of ketoconazole 200 mg/day increased alfuzosin Cmax by 2.1-fold and AUC by 2.5-fold following a single 10 mg dose.

MANAGEMENT: Concomitant use of alfuzosin with potent CYP450 3A4 inhibitors such as itraconazole, ketoconazole, posaconazole, voriconazole, conivaptan, nefazodone, cobicistat, delavirdine, protease inhibitors, and ketolide and certain macrolide antibiotics is considered contraindicated. Some authorities recommend avoiding concomitant use of alfuzosin during and for 2 weeks after treatment with itraconazole.

References

  1. (2002) "Product Information. Sporanox (itraconazole)." Janssen Pharmaceuticals
  2. (2003) "Product Information. Uroxatral (alfuzosin)." sanofi-aventis
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. EMEA. European Medicines Agency (2007) EPARs. European Union Public Assessment Reports. http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid
  5. Cerner Multum, Inc. "Australian Product Information."
View all 5 references

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Drug and food interactions

Moderate

alfuzosin food

Applies to: alfuzosin

ADJUST DOSING INTERVAL: Administration of alfuzosin with food enhances oral bioavailability. According to the manufacturer, extent of absorption is 50% higher when administered under fed conditions compared to fasting conditions.

MANAGEMENT: To ensure maximal oral absorption, alfuzosin should be administered with or immediately after a meal.

References

  1. (2003) "Product Information. Uroxatral (alfuzosin)." sanofi-aventis

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Minor

tenofovir food

Applies to: AccessPak for HIV PEP Expanded with Viracept (emtricitabine / nelfinavir / tenofovir)

Food enhances the oral absorption and bioavailability of tenofovir, the active entity of tenofovir disoproxil fumarate. According to the product labeling, administration of the drug following a high-fat meal increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of tenofovir by approximately 14% and 40%, respectively, compared to administration in the fasting state. However, administration with a light meal did not significantly affect the pharmacokinetics of tenofovir compared to administration in the fasting state. Food delays the time to reach tenofovir Cmax by approximately 1 hour. Tenofovir disoproxil fumarate may be administered without regard to meals.

References

  1. (2001) "Product Information. Viread (tenofovir)." Gilead Sciences

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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