Drug-Drug Interactions in the Treatment of HIV

Faculty:

Courtney V. Fletcher, PharmD

Learning Objectives

Upon completion of this activity, participants should be able to:

• Discuss the most common mechanisms underlying drug-drug interactions between antiretroviral agents and other medications commonly used by HIV-infected patients
• Describe common drug-drug interactions affecting US Food and Drug Administration–approved antiretroviral agents and detail dose adjustments where appropriate
• List combinations of antiretroviral agents and other medications that are contraindicated
• Summarize common drug-drug interactions affecting investigational antiretrovirals currently available through expanded access programs

Topics covered include:

• Pharmacologic Concepts in the Study of Drug-Drug Interactions
• Pharmacokinetics: Drug Absorption and Distribution
• Pharmacokinetics: Drug Elimination
• Pharmacodynamics and Exposure-Response Relationships
• Pharmacokinetic Variability
• Interactions Affecting Drug Absorption and Disposition: An Overview
• Interactions Affecting Drug Absorption: Antiretrovirals and Antacids, H2 Antagonists, and Proton Pump Inhibitors
• Interactions Affecting Drug Disposition: Atazanavir and Rifampin
• Interactions Affecting Drug Disposition: Double-Boosted PI Combinations
• Interactions Affecting Drug Disposition: Tipranavir and Other PIs or NNRTIs
• Interactions Affecting Drug Disposition: Tenofovir and Various PIs
• Interactions Affecting Investigational Agents in Expanded Access Programs: Maraviroc and PIs and NNRTIs
• Interactions Affecting Investigational Agents in Expanded Access Programs: Etravirine, Other Antiretrovirals, and Other Agents
• Interactions Affecting Investigational Agents in Expanded Access Programs: Raltegravir and Other Antiretrovirals
• Challenges in the Management of Drug-Drug Interactions: Recommendations for Coadministration of Efavirenz and Rifampin
• Conclusions