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Drug Interactions between emtricitabine / lopinavir / ritonavir / tenofovir and Incivek

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

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Interactions between your drugs

Moderate

ritonavir tenofovir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir and emtricitabine / lopinavir / ritonavir / tenofovir

Ritonavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

lopinavir tenofovir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir and emtricitabine / lopinavir / ritonavir / tenofovir

Lopinavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

ritonavir telaprevir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir and Incivek (telaprevir)

Ritonavir may alter the blood levels and effects of telaprevir, depending on what other HIV medications you are using. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

lopinavir telaprevir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir and Incivek (telaprevir)

Talk to your doctor before using telaprevir together with lopinavir. Combining these medications may decrease the blood levels of telaprevir, which may reduce its effectiveness in treating hepatitis C. Your doctor may be able to prescribe alternatives that do not interact. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

tenofovir telaprevir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir and Incivek (telaprevir)

Telaprevir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

ritonavir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir

Ritonavir should be taken with food to lessen gastrointestinal side effects. It is important that you take this medication exactly as prescribed by your doctor. Do not change your treatment or stop treatment without first talking to your doctor.

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Moderate

lopinavir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir

Food may affect the absorption of lopinavir-ritonavir (brand name Kaletra) depending on whether you are taking the oral solution or the tablet. The oral solution should be taken with food to enhance absorption and help it work better. The tablet formulation can be take with or without food. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

telaprevir food

Applies to: Incivek (telaprevir)

Food significantly increases the absorption of telaprevir. Within 30 minutes before you take each dose of telaprevir, you should eat a meal or snack containing approximately 20 grams of fat. Taking it on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication. Examples of some foods that could be taken with telaprevir include: bagel with cream cheese; half cup of nuts; 3 tablespoons of peanut butter; 1 cup of ice cream; 2 ounces of American or cheddar cheese; 2 ounces of potato chips; or half cup of trail mix. Talk to your healthcare provider if you have additional questions about how to take telaprevir.

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Minor

tenofovir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Protease inhibitors

Therapeutic duplication

The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'protease inhibitors' category:

  • emtricitabine/lopinavir/ritonavir/tenofovir
  • Incivek (telaprevir)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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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.