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Drug Interactions between etravirine and voriconazole

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

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Interactions between your drugs

Moderate

voriconazole etravirine

Applies to: voriconazole and etravirine

MONITOR: Coadministration of etravirine and voriconazole may result in increased plasma concentrations of both drugs. Etravirine is a substrate of CYP450 2C19, 2C9 and 3A4 as well as an inhibitor of CYP450 2C19 and 2C9, while voriconazole is a substrate of CYP450 2C19 and inhibitor of CYP450 2C19, 2C9 and 3A4. Theoretically, etravirine can inhibit the metabolism of voriconazole via CYP450 2C19, and voriconazole can inhibit the metabolism of etravirine via CYP450 2C19, 2C9 and 3A4.

MANAGEMENT: Because safety data regarding increased etravirine exposures are limited, caution is advised if etravirine is prescribed in combination with voriconazole. Dosage adjustments may be required for one or both drugs if undue adverse effects occur.

References (1)
  1. (2008) "Product Information. Intelence (etravirine)." Ortho Biotech Inc

Drug and food interactions

Moderate

voriconazole food

Applies to: voriconazole

ADJUST DOSING INTERVAL: Food reduces the oral absorption and bioavailability of voriconazole. According to the product labeling, administration of multiple doses of voriconazole with high-fat meals decreased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 34% and 24%, respectively, when the drug is administered as a tablet, and by 58% and 37%, respectively, when administered as the oral suspension.

MANAGEMENT: To ensure maximal oral absorption, voriconazole tablets and oral suspension should be taken at least one hour before or after a meal.

References (2)
  1. (2002) "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals
  2. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67
Moderate

etravirine food

Applies to: etravirine

ADJUST DOSING INTERVAL: Coadministration with food increases the oral bioavailability of etravirine. The mechanism is unknown. Compared to administration following a meal, the systemic exposure (AUC) to etravirine was decreased by about 50% when the drug was administered under fasting conditions. The types of meal studied (ranging from 345 kilocalories containing 17 grams fat to 1160 kilocalories containing 70 grams fat) did not appear to make a difference with respect to impact on etravirine bioavailability.

MANAGEMENT: Etravirine should always be administered following a meal.

References (1)
  1. (2008) "Product Information. Intelence (etravirine)." Ortho Biotech Inc

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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