Drug Interaction Report

MONITOR: Coadministration with strong CYP450 3A4 inhibitors may increase plasma concentrations and the risk of adverse effects of clindamycin, which is metabolized predominantly by the isoenzyme.

MANAGEMENT: Caution is advised if clindamycin is used concomitantly with strong CYP450 3A4 inhibitors. The possibility of adverse reactions to clindamycin should be considered during coadministration with strong CYP450 3A4 inhibitors. Dosage adjustments as well as clinical and laboratory monitoring of clindamycin should be considered whenever a strong CYP450 3A4 inhibitor is added to or withdrawn from therapy.

MONITOR: Coadministration with strong CYP450 3A4 inhibitors may increase plasma concentrations and the risk of adverse effects of clindamycin, which is metabolized predominantly by the isoenzyme.

MANAGEMENT: Caution is advised if clindamycin is used concomitantly with strong CYP450 3A4 inhibitors. The possibility of adverse reactions to clindamycin should be considered during coadministration with strong CYP450 3A4 inhibitors. Dosage adjustments as well as clinical and laboratory monitoring of clindamycin should be considered whenever a strong CYP450 3A4 inhibitor is added to or withdrawn from therapy.

ADJUST DOSING INTERVAL: Administration of atazanavir with food enhances oral bioavailability and reduces pharmacokinetic variability. According to the manufacturer, administration with a light meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single 400 mg dose of atazanavir by 57% and 70%, respectively, relative to the fasting state. Administration with a high-fat meal resulted in a mean increase of 35% in atazanavir AUC and no change in Cmax compared to fasting. The coefficient of variation of AUC and Cmax decreased by approximately one-half when given with either a light or high-fat meal compared to the fasting state.

MANAGEMENT: To ensure maximal oral absorption, atazanavir should be administered with or immediately after a meal.