Drug Interaction Report

Serum concentrations and effects of medications that are metabolized by the 3A4 enzymatic pathways may theoretically be elevated in patients receiving delavirdine. The mechanism is inhibition of these enzymes by delavirdine. The clinical significance is unknown. Monitoring for clinical and laboratory evidence of safety and tolerance is recommended. Dosage adjustments or alternatives may be needed if an interaction is suspected.

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.