Gastrointestinal symptoms, Avoid inducers of p-glycoprotein alafenamide elvitegravir/cobicistat; 25 mg qd with headache, ↑ creatinine, (rifampin, rifabutin, phenytoin, emtricitabine ± rilpivirine proteinuria phenobarbital, St John’s Wort, tipranavir/ ritonavir). Also avoid in severe renal insufficiency.
Nausea, diarrhea, vomiting, Avoid atazanavir, didanosine, probenecid. proxil fumarate flatulence, headache, renal insufficiency
Tipranavir PI2 500 mg bid with ritonavir 200 mg bid Take with food. Separate Diarrhea, nausea, vomiting, See footnote 4. Avoid concurrent atafrom ddI by ≥2 h. Avoid abdominal pain, rash, ↑ liver zanavir, elvitegravir/cobicistat, etravirine, antacids. enzymes, hyperlipidemia fosamprenavir, lopinavir/ritonavir, saquinavir. Avoid in patients with severe hepatic insufficiency, who are at risk for bleeding, or with sulfa allergy. Avoid vitamin E with the oral solution.
1All NRTI agents carry the risk of lactic acidosis with hepatic steatosis as a potential adverse event.
2All PI agents carry the risk of hyperlipidemia, fat maldistribution, hyperglycemia, and insulin resistance as potential adverse events.
3Adjust dose in renal insufficiency.
4Because of altered systemic exposures, concurrent drugs that interact with the CYP3A4 system should be used with caution, including alfuzosin, amiodarone, aprepitant, artemether/lumefantrine, astemizole, atovaquone, benzodiazepines (diazepam, midazolam, triazolam), bexarotene, bepridil, bosentan, bupropion, calcium channel blockers (diltiazem, felodipine, nifedipine, nimodipine, verapamil), carbamazepine, ceritinib , cimetidine, cisapride, clopidogrel, colchicine, conivaptan, corticosteroids, cyclosporine, dabrafenib, dapsone, desipramine, direct Factor Xa inhibitors (apixaban, rivaroxaban), disopyramide, dofetilide, dronedarone, enzalutamide, ergot alkaloid derivatives, ethinyl estradiol/norethindrone acetate, flecainide, fluticasone, gestodene, idelalisib, irinotecan, ivacaftor, levodopa, lidocaine, lumacaftor, lurasidone, macrolide agents (clarithromycin, telithromycin), methadone, mitotane, nafcillin, PDE5 inhibitors, phenobarbital, phenytoin, pimozide, primidone, propafenone, protein pump inhibitors, quinidine, ranolazine, rifabutin, salmeterol, spironolactone, statin agents, St. John’s wort, tacrolimus, triazole antifungal agents (itraconazole ketoconazole, posaconazole, voriconazole), terfenadine, and warfarin.
INSTI, integrase strand transfer inhibitor; NNRTI, nonnucleoside reverse transcriptase inhibitor; NRTI, nucleoside/nucleotide reverse transcriptase inhibitor; PI, protease inhibitor.