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Drug Interactions between letermovir and Viramune XR

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

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Interactions between your drugs

Moderate

nevirapine letermovir

Applies to: Viramune XR (nevirapine) and letermovir

GENERALLY AVOID: Coadministration with letermovir may increase the plasma concentrations of drugs that are CYP450 3A4 substrates, such as bosentan and nevirapine. Additionally, coadministration of letermovir with inducers of the P-glycoprotein (P-gp) efflux transporter and/or the uridine diphosphate glucuronosyltransferase (UGT) enzymes, such as bosentan and nevirapine may decrease the plasma concentrations of letermovir leading to loss of efficacy of letermovir. Drug interaction studies performed to assess the degree of CYP450 3A4 inhibition between letermovir and midazolam (CYP450 3A4 probe substrate) show the net effect of letermovir inhibition on CYP450 3A4 as moderate. According to the product labeling, coadministration of bosentan or nevirapine with letermovir may decrease letermovir plasma concentrations possibly due to P-gp and/or UGT induction.

MANAGEMENT: Coadministration of bosentan or nevirapine with letermovir is not recommended due to the potential loss of efficacy of letermovir. If letermovir is added to or withdrawn from therapy with drugs that are substrates of CYP450 3A4 such as bosentan and nevirapine, dosage adjustments and clinical and laboratory monitoring of bosentan and nevirapine is recommended. Moreover, clinicians should be aware that the magnitude of CYP450 3A-mediated drug interactions with coadministered drugs may be different when letermovir is used with cyclosporine.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Prevymis (letermovir)." Merck & Co., Inc (2017):

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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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