CIPLADOC - AIDS Update - DRUG INTERACTIONS IN HIV THERAPY - DRUG INTERACTIONS BETWEEN PROTEASE INHIBITORS

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DRUG INTERACTIONS IN HIV THERAPY
A Clinician's Guide

DRUG INTERACTIONS BETWEEN PROTEASE INHIBITORS

Effect of Drug on Levels (AUCs)/Dose

Drugs Affected	Ritonavir (RTV)	Saquinavir** (SQV)	Nelfinavir *(NFV)	Amprenavir (APV)	Lopinavir/ Ritonavir
Indinavir (IDV)	Levels: IDV h2-5X Dose: IDV 400 mg bid + RTV 400 mg bid, or IDV 800 mg bid + RTV 100 mg bid	Levels: IDV no effect SQV h 4-7x Dose: Insufficient data	Levels: IDV h 50% NFV NFV h 80% Dose: Limited data for IDV 1200 mg bid + NFV 1250 mg bid	Levels: APV AUC h 33% Dose: no change	Levels: IDV AUC and Cmin increased Dose: IDV 600 mg bid
Ritonavir (RTV)		Levels: RTV no effect SQV 20x+# Dose: SQV hard or soft gel capsules 400 mg bid + RTV 400 mg bid	Levels: RTV no effect NFVh 1.5 x Dose: RTV 400 mg bid + NFV 500-750mg bid	Levels: APV AUCh 2.5 fold Dose: Limited data for APV 600-1200 mg bid + RTV 100-200 mg bid
Saquinavir (SQV)			Levels: SQV h 3-5x NFV h20%# Dose: Standard NFV SQV soft gel capsules 800 mg tid or 1200 mg bid	Levels: APV AUCi32% Dose: Insufficient data	Levels : SQV# AUC and Cmin increased Dose : SQV 800 mg bid, LPV/r standard
Nelfinavir (NFV)				Levels: APV AUC h 1.5-fold Dose: insufficient data	No data
Amprenavir (APV)					Levels: APV AUC and Cmin increased Dose: APV 600- 750 mg bid, LPV/r standard
* Several drug interaction studies have been completed with Saquinavir given as hard gel or soft gel capsules. Results from studies conducted with hard gel capsules may not be applicable to soft gel capsules + Conducted with SQV hard gel capsules # Conducted with SQV soft gel capsules