Appendix 2 Interactions Between Antiretrovirals and Drugs Commonly Used to Treat Cardiovascular Disease
Interactions among protease inhibitors (PIs) and drugs used to treat cardiovascular diseases
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Light red shadowing indicates major interactions; yellow shadowing indicates moderate interactions; light blue shadowing indicates minor interactions.
AUC, area under the curve; INR, international normalized ratio
Interactions among nucleoside reverse transcriptase inhibitors (NRTI) and nucleotide reverse transcriptase inhibitors (NtRTI) and drugs used to treat cardiovascular diseases
| NRTI | Abacavir | Zidovudine | Lamivudine | Zalcitabine | Stavudine | Didanosine | Tanofovir |
| Ca++ channel blocker | None | ||||||
| Antiarrhythmics | |||||||
| Amiodarone | None | None | None | None | None | None | None |
| Flecainide | None | None | None | None | None | None | None |
| Propafenone | None | None | None | None | None | None | None |
| Quinidine | None | None | None | None | None | None | None |
| Statins | |||||||
| Quinidine | None | None | None | None | None | None | None |
| Lovastatin | None | None | None | None | None | None | None |
| Pravastatin | None | None | None | None | None | None | None |
| Simvastatin | None | None | None | None | None | None | None |
| Atorvarstatin | None | None | None | None | None | None | None |
| Anticoagulants | |||||||
| Warfarin | None | None | None | None | None | None | None |
Interactions among non-nucleoside reverse transcriptase inhibitors (NNRTI) and drugs used to treat cardiovascular diseases
| NNRTI | Delavirdine | Nevirapine | Efavirenz |
| Ca++ channel blocker | None | None | bgcolor=white>None|
| Antiarrhythmics | |||
| Amiodarone | None | None | None |
| Flecainide | None | None | None |
| Propafenone | None | None | None |
| Quinidine | None | None | None |
| Statins | ||||||
| Fluvastatin | Affected drug: Fluvastatin Interacting drug: Delavirdine Mechanism: Inhibition of metabolism - potential for increased levels and toxicity RecommendaCimt: Potential for hypolipidemic toxicity (dizziness, headache, GI side effects). Monitor patient closely and consider dose reduction | None | None | |||
| Lovastatin | Affected drug: Lovastatin Interacting drug: Delavirdine Mechanism: Inhibition of metabolism - potential for increased levels and toxicity Recomm&idatwn: Potential for hypolipidemic toxicity (dizziness, headache, GI side effects). Monitor patient closely and consider dose reduction | None | None | |||
| Pravastatin | Affected drug: Pravastatin Interacting drug: Delavirdine Mechanism: Inhibition of metabolism - potential for increased levels and toxicity Recommee^t^t^n: Potential for hypolipidemic toxicity (dizziness, headache, GI side effects). Monitor patient closely and consider dose reduction | None | None | |||
| Simvastatin | Affected drug: Simvastatin Interacting drug: Delavirdine Mechanism: Inhibition of metabolism - potential for increased levels and toxicity Potential for hypolipidemic toxicity (dizziness, headache, GI side effects). Monitor patient closely and consider dose reduction | None | None | |||
| Atorvastatin | Affected drug: Atorvastatin Interacting drug: Delavirdine Mechanism: Inhibition of metabolism - potential for increased levels and toxicity Potential for hypolipidemic toxicity (dizziness, headache, GI side effects). Monitor patient closely and consider dose reduction | None | None | |||
| Anticoagulants | ||||||
| Warfarin | Affected drug: Warfarin Interacting drug: Delavirdine Mechanism: Inhibition of metabolism - potential for increased risk of bleeding Recommendation: Monitor INR closely or avoid concomitant use | Affected drug: Warfarin Interacting drug: Nevirapine Mechanism: Induction of metabolism - decreased anticoagulation and risk of blood clot or embolus Recommendation: Monitor INR closely or avoid concomitant use | Affected drug: Warfarin Interacting drug: Efavirenz Mechanism: Induction of metabolism - decreased anticoagulation and risk of blood clot or embolus Recommendation: Monitor INR closely or avoid concomitant use | |||
Light red shadowing indicates major interactions; yellow shadowing indicates moderate interactions; light blue shadowing indicates minor interactions.
AUC, area under the curve; INR, international normalized ratio
Reference
1. Volberding P, Murphy R, Barbaro G et al (2003) The Pavia Consensus Statement. AIDS 17(S1):S170-S179