Drug Interaction Report

Coadministration with potent or moderate CYP450 3A4 inhibitors may increase the plasma concentration of meloxicam. In vitro studies indicate that meloxicam is primarily metabolized by CYP450 2C9 with a minor contribution from CYP450 3A4. Clinical studies relating to this interaction are unavailable. NSAID related side effects and toxicity may occur with this combination.

ADJUST DOSING INTERVAL: Food enhances the absorption and oral bioavailability of darunavir administered in combination with low-dose ritonavir. The mechanism is unknown. When administered with food, the peak plasma concentration (Cmax) and area under the plasma concentration-time curve (AUC) of darunavir were approximately 30% higher than when administered in the fasting state. Darunavir exposure was similar for the range of meals studied. The total caloric content of the various meals evaluated ranged from 240 Kcal (12 grams fat) to 928 Kcal (56 grams fat).

MANAGEMENT: To ensure maximal oral absorption, darunavir coadministered with ritonavir should be taken with food. The type of food is not important.