Protease Inhibitors: DRUG INTERACTIONS

Protease Inhibitors

DRUG INTERACTIONS with Norvir (ritonavir) 4/10/96

By Jules Levin, Executive Director of NATAP

The following list was compiled and distributed by Abbott Labs.

drug class	generic name	brand name	generic name	brand name	# patients
Norvir should NOT be coadministered with:			Potential alternatives (may not be therapeutically equivalent):
analgesic	meperidine piroxicam propoxyphene	Demoral Feldene Darvon	acetaminophen aspirin oxycodone	Tylenol Percodan	n=135 n=43 n=23
cardiovascular (antiarrhythmic)	amiodarone encainide flecainide propafenone quinidine	Cordarone Enkaid Tambocor Rythmol	- very limited clinical experience-
anti-mycobacterial	rifabutin	Mycobutin	clarithromycin ethambutol	Biaxin Myambutol	n=156 n=66
cardiovascular (calcium channel blocker)	bepridil	Vascor	-very limited clinical experience-
cold & allergy (antihistimine)	astemizole terfenadine	Hismanal Seldane	loratadine	Claritin	n=36
gastrointestinal	cisapride	Propulsid	-very limited clinical experience-
psychotropic (antidepressant)	bupropion	Wellbutrin	fluoxetine desipramine	Prozac Nopramin	n=28
psychotropic (neuroleptic)	clozapine	Clozaril	-very limited clinical experience-
psychotropic (sedative/hypnotic)	aplrazolam clorazepate diazepam estazolam flurazepam midazolam triazolam zolpidem	Xanax Tranxene Valium Prosom Dalmane Versed Halcion Ambien	temazepam lorazepam	Restonil Ativan	n=60 n=33

DO NOT CO-ADMINISTER antabuse with Norvir. Ritonavir contains alcohol, which can produce reactions when coadministered with disulfiram (antabuse) or other drugs that produce disulfiram-like reactions (e.g., metronidazole).

see the PRECAUTIONS-DRUG INTERACTIONS and the DRUG-DRUG INTERACTIONS sections of the Norvir package insert for more information about actual and potential effects on drugs coadministered with Norvir; this package insert is available at your pharmacy.

The following statements are quoted from the Abbott package insert. Please, refer to the insert for elaboration of the subjects.

Tobacco use is associated with an 18% decrease in the AUC (blood levels) of ritonavir."
Relative to fasting conditions, the extent of absorption of ritonavir from the capsule formulation was 15% higher when administered with a meal (771 KCal; 46% fat, 18% protein, and 37% carbohydrate)." -- see the PHARMACOKINETICS section of the package insert.

See also, Letter from Abbott sent to doctors.

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About the author: Jules Levin is the Executive Director of NATAP, based in New York City.

The National AIDS Treatment Advocacy Project (NATAP) is a New York State non-profit corporation dedicated to facilitating the effort for development of effective treatment for HIV.

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