Drug Interactions between emtricitabine / nelfinavir / tenofovir and Tracleer
This report displays the potential drug interactions for the following 2 drugs:
- emtricitabine/nelfinavir/tenofovir
- Tracleer (bosentan)
Interactions between your drugs
nelfinavir bosentan
Applies to: emtricitabine / nelfinavir / tenofovir and Tracleer (bosentan)
ADJUST DOSE: Coadministration of a protease inhibitor (PI) in combination with bosentan may increase the plasma concentration of bosentan and decrease that of the PI, unless ritonavir is included as a pharmacokinetic booster. Both PIs and bosentan are primarily metabolized by CYP450 3A4. Because PIs are also inhibitors of CYP450 3A4, they can inhibit the metabolic clearance of bosentan. Conversely, bosentan may induce the metabolism of PIs, although the effects are probably not significant in the presence of ritonavir, which is a potent CYP450 3A4 inhibitor.
MANAGEMENT: Protease inhibitors should generally not be used in combination with bosentan unless ritonavir is also added as a pharmacokinetic booster. Dose adjustment of bosentan has been recommended. In patients who are starting bosentan and have been receiving PI therapy for at least 10 days, it has been recommended to start bosentan at 62.5 mg once daily or every other day based upon individual tolerability. When starting PI therapy in patients already on bosentan, it has been recommended to discontinue bosentan for at least 36 hours prior to initiation of PI therapy. After at least 10 days following the initiation of PI therapy, bosentan may be resumed at 62.5 mg once daily or every other day based upon individual tolerability. According to some authorities, use of the fixed combination atazanavir-cobicistat with bosentan is not recommended.
References
- (2001) "Product Information. Invirase (saquinavir)." Roche Laboratories
- (2001) "Product Information. Crixivan (indinavir)." Merck & Co., Inc
- (2001) "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc
- (2001) "Product Information. Kaletra (lopinavir-ritonavir)." Abbott Pharmaceutical
- (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb
- (2003) "Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline
- (2005) "Product Information. Aptivus (tipranavir)." Boehringer-Ingelheim
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2006) "Product Information. Prezista (darunavir)." Ortho Biotech Inc
- Cerner Multum, Inc. "Australian Product Information."
- (2015) "Product Information. Evotaz (atazanavir-cobicistat)." Bristol-Myers Squibb
Drug and food interactions
tenofovir food
Applies to: 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
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