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Drug Interactions between Agenerase and Isentress HD

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

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Interactions between your drugs

Moderate

amprenavir raltegravir

Applies to: Agenerase (amprenavir) and Isentress HD (raltegravir)

MONITOR: Coadministration of fosamprenavir (with or without ritonavir) and raltegravir may decrease the plasma concentrations of both amprenavir and raltegravir. The mechanism of interaction has not been described. In 14 study subjects, administration of fosamprenavir 1400 mg twice a day (under fasting conditions) in combination with raltegravir 400 mg twice a day for 14 days decreased the amprenavir peak plasma concentration (Cmax), systemic exposure (AUC) and trough plasma concentration (Cmin) by 27%, 36% and 43%, respectively. When the same dosages were given without regards to food, amprenavir Cmax, AUC and Cmin decreased by 15%, 17% and 32%, respectively. In 14 study subjects, administration of fosamprenavir 700 mg plus ritonavir 100 mg twice a day (under fasting conditions) in combination with raltegravir 400 mg twice a day for 14 days decreased the amprenavir Cmax, AUC and Cmin by 14%, 17% and 20%, respectively. When the same dosages were given without regards to food, amprenavir Cmax, AUC and Cmin decreased by 15%, 17% and 32%, respectively. In 13 study subjects, administration of fosamprenavir 1400 plus ritonavir 100 mg once a day (under fasting conditions) in combination with raltegravir 400 mg twice a day for 14 days decreased the amprenavir Cmax, AUC and Cmin by 18%, 24% and 50%, respectively. When the same dosages were given without regards to food, amprenavir Cmax and AUC increased by 27% and 13%, respectively, but the Cmin decreased by 17%.

MANAGEMENT: Caution is advised if fosamprenavir is prescribed in combination with raltegravir. Appropriate dosages of the combination with respect to safety and efficacy have not been established.

References

  1. (2003) "Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline

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Drug and food interactions

Moderate

amprenavir food

Applies to: Agenerase (amprenavir)

GENERALLY AVOID: Administration with a high-fat meal may decrease the oral bioavailability of amprenavir. The mechanism is unknown. In healthy volunteers, consumption of a standardized high-fat meal decreased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of amprenavir (1200 mg single oral dose) by 36% and 21%, respectively, compared to administration in the fasted state. The time to reach Cmax (Tmax) was increased 44% following a high-fat meal.

Grapefruit juice does not appear to significantly affect the pharmacokinetics of amprenavir. In 12 healthy volunteers, administration with grapefruit juice (200 mL) decreased the mean peak plasma concentration (Cmax) of amprenavir (1200 mg single oral dose) by 22% compared to water. The median time to reach Cmax (Tmax) was prolonged from 0.75 to 1.13 hours. These pharmacokinetic changes are not thought to be clinically significant, since antiretroviral response is more closely associated with systemic exposure (AUC) and trough plasma concentration (Cmin), which were not affected in the study.

MANAGEMENT: Amprenavir may be taken with or without food, but should not be taken with a high-fat meal.

References

  1. (2001) "Product Information. Agenerase (amprenavir)." Glaxo Wellcome
  2. Demarles D, Gillotin C, Bonaventure-Paci S, Vincent I, Fosse S, Taburet AM (2002) "Single-dose pharmacokinetics of amprenavir coadministered with grapefruit juice." Antimicrob Agents Chemother, 46, p. 1589-1590

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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.

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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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