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

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

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Interactions between your drugs

Moderate

ivermectin nelfinavir

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

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of ivermectin and the risk of adverse effects. The proposed mechanism, based on in vitro data, is decreased clearance due to inhibition of CYP450 3A4, the primary isoenzyme responsible for the metabolic clearance of ivermectin.

MANAGEMENT: Caution is advised when ivermectin must be used concomitantly with potent CYP450 3A4 inhibitors. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate whenever a potent CYP450 3A4 inhibitor is added to or withdrawn from therapy.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Zeng Z, Andrew NW, Arison BH, Luffer-Atlas D, Wang RW "Identification of cytochrome P4503A4 as the major enzyme responsible for the metabolism of ivermectin by human liver microsomes." Xenobiotica 28 (1998): 313-21

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Drug and food interactions

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

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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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