OBJECT DRUGS

Antivirals:

• Amprenavir (Agenerase)
• Atazanavir (Reyataz)
• Daclatasvir (Daklinza)
• Darunavir (Prezista)
• Delavirdine (Rescriptor)
• Etravirine (Intelence)
• Fosamprenavir Lexiva
• Indinavir (Crixivan)
• Lopinavir (Kaletra)
• Maraviroc (Selzentry)
• Nelfinavir (Viracept)
• Rilpivirine (Edurant)
• Ritonavir (Norvir)
• Saquinavir (Invirase)
• Telaprevir (Incivek)

PRECIPITANT DRUGS

Antidepressants:

• Fluvoxamine (Luvox, etc.)
• Nefazodone

Comment:

Inhibitors of CYP3A4 may increase the serum levels of these antivirals resulting in increased side effects.

Class 3: Assess Risk & Take Action if Necessary

• Consider Alternative: Sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), venlafaxine (Effexor), and paroxetine (Paxil) appear less likely to inhibit CYP3A4 than fluvoxamine. Fluoxetine (Prozac) appears to be a weak inhibitor of CYP3A4, but little is known about the effect of other antidepressants on antivirals.
• Circumvent/Minimize: Consider reducing the dose of the antiviral if enzyme inhibitors are coadministered.
• Monitor:Monitor for antiviral toxicity.