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

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

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Interactions between your drugs

Major

omeprazole nelfinavir

Applies to: Zegerid (omeprazole / sodium bicarbonate) and AccessPak for HIV PEP Expanded with Viracept (emtricitabine / nelfinavir / tenofovir)

GENERALLY AVOID: Concurrent use of inhibitors of the proton pump (PPIs or potassium-competitive acid blockers [PCABs]) may decrease the oral bioavailability of nelfinavir and reduce its concentrations in plasma. Nelfinavir solubility may decrease with increasing pH, thus inhibition of gastric acid secretion may interfere with dissolution of the drug. In one study, administration of omeprazole (40 mg once daily) 30 minutes before nelfinavir (1250 mg twice a day) for 4 days reduced the peak plasma concentration, trough plasma concentration, and systemic exposure (AUC) of nelfinavir by a little over one-third.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, use of inhibitors of the proton pump is not recommended in patients treated with nelfinavir.

References

  1. "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc PROD (2001):
  2. Durant J, Clevenbergh P, Garraffo R, Halfon P, Icard S, DelGiudice P, Montagne N, Schapiro JM, Dellamonica P "Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study." Aids 14 (2000): 1333-9
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Fang AF, Damle BD, Labadie RR, Crownover PH, Hewlett D, Glue PW "Significant decrease in nelfinavir systemic exposure after omeprazole coadministration in healthy subjects." Pharmacotherapy 28 (2008): 42-50
  5. "Product Information. Voquezna Dual Pak (amoxicillin-vonoprazan)." Phathom Pharmaceuticals, Inc ORIG-1 (2022):
  6. "Product Information. Voquezna Triple Pak (amoxicillin/clarithromycin/vonoprazan)." Phathom Pharmaceuticals, Inc ORIG-1 (2022):
View all 6 references

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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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