DRUG
INTERACTIONS IN HIV THERAPY A Clinician's Guide
DRUG-FOOD INTERACTIONS
IN HIV-INFECTED PATIENTS
Drugs
Food Effect
Recommendations
Atovaquone
High fat meal may increase bioavailability
up to 3-fold
Administer with food
Didanosine
Administration
with food results in 55% decrease in AUC
Administer
on empty stomach at least 30 minutes before a Administer
with food
Ganciclovir
(capsules)
Indinavir
High
fat meal results in 22%
increase in AUC
High fat, protein, caloric meal results in 77% decrease
in AUC. However, indinavir combined with ritonavir (400
mg q12h each) taken with food achieves similar IDV exposure
to standard t.i.d. regimen
Administer
indinavir on empty stomach or with low fat, light meal.
No food restriction if administered with ritonavir
Itraconazole
(capsules)
Significant
increase in bioavailability when taken with a full meal
Administer
with food
Itraconazole
(solution)
Maximal
absorption when taken under fasting conditions
Recommended
to be taken without food if possible
Nelfinavir
AUC
2-3 fold higher when given with food
Administer
with meal or light snack
Ritonavir
Food
results in 15% increase in AUC
Recommended
to be taken with meals if possible
Saquinavir
(hard or soft gel capsules)
Marked
increase in AUC following high fat meal
Administer
within 2 hours after a full meal
Saquinavir
(hard or soft gel capsules)
Grapefruit
juice increases saquinavir concentrations
40%-100% due to inhibition of gut metabolism
Grapefruit
juice may be given to patients receiving saquinavir
