Drug Interactions between AccessPak for HIV PEP Expanded with Viracept and Griseofulicin
This report displays the potential drug interactions for the following 2 drugs:
- AccessPak for HIV PEP Expanded with Viracept (emtricitabine/nelfinavir/tenofovir)
- Griseofulicin (griseofulvin)
Interactions between your drugs
griseofulvin nelfinavir
Applies to: Griseofulicin (griseofulvin) and AccessPak for HIV PEP Expanded with Viracept (emtricitabine / nelfinavir / tenofovir)
MONITOR: Coadministration with drugs that are inducers of CYP450 3A4 may decrease the plasma concentrations of protease inhibitors (PIs), which are primarily metabolized by the isoenzyme.
MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, protease inhibitors should be used cautiously with agents that induce CYP450 3A4, particularly if only one PI is used in the antiretroviral regimen. Coadministration of atazanavir without ritonavir and carbamazepine, phenobarbital, or phenytoin is not recommended. Antiretroviral response should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the antiretroviral regimen adjusted as necessary.
References
- (2001) "Product Information. Invirase (saquinavir)." Roche Laboratories
- (2001) "Product Information. Crixivan (indinavir)." Merck & Co., Inc
- (2001) "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc
- Brooks J, Daily J, Schwamm L (1997) "Protease inhibitors and anticonvulsants." AIDS Clin Care, 9, 87,90
- Barry M, Gibbons S, Back D, Mulcahy F (1997) "Protease inhibitors in patients with HIV disease. Clinically important pharmacokinetic considerations." Clin Pharmacokinet, 32, p. 194-209
- (2001) "Product Information. Agenerase (amprenavir)." Glaxo Wellcome
- Acosta EP, Henry K, Baken L, Page LM, Fletcher CV (1999) "Indinavir concentrations and antiviral effect." Pharmacotherapy, 19, p. 708-12
- Sommadossi JP (1999) "HIV protease inhibitors: pharmacologic and metabolic distinctions." AIDS, 13, s29-40
- Hugen PWH, Burger DM, Brinkman K, terHofstede HJM, Schuurman R, Koopmans PP, Hekster YA (2000) "Carbamazepine-indinavir interaction causes antiretroviral therapy failure." Ann Pharmacother, 34, p. 465-70
- Durant J, Clevenbergh P, Garraffo R, Halfon P, Icard S, DelGiudice P, Montagne N, Schapiro JM, Dellamonica P (2000) "Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study." Aids, 14, p. 1333-9
- (2001) "Product Information. Fortovase (saquinavir)." Roche Laboratories
- (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb
- (2003) "Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline
- Liedtke MD, Lockhart SM, Rathbun RC (2004) "Anticonvulsant and antiretroviral interactions." Ann Pharmacother, 38, p. 482-9
- (2005) "Product Information. Aptivus (tipranavir)." Boehringer-Ingelheim
- (2006) "Product Information. Prezista (darunavir)." Ortho Biotech Inc
- Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
Drug and food interactions
griseofulvin food
Applies to: Griseofulicin (griseofulvin)
MONITOR: Isolated case reports have suggested that the ingestion of alcohol during griseofulvin therapy may rarely cause disulfiram-like reactions, flushing, tachycardia, or increased effects of alcohol. The mechanism is unknown.
MANAGEMENT: Patients should be advised of the possibility of increased adverse effects or a disulfiram-like reaction.
References
- "Product Information. Grifulvin V (griseofulvin)." Ortho McNeil Pharmaceutical
- (2002) "Product Information. Fulvicin P/G (griseofulvin)." Schering Corporation
- Cerner Multum, Inc. "Australian Product Information."
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
- (2001) "Product Information. Viread (tenofovir)." Gilead Sciences
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
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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