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

Enzyme Inhibitors:

• Amiodarone (Cordarone, etc.)
• Amprenavir (Agenerase)
• Aprepitant (Emend)
• Atazanavir (Reyataz)
• Boceprevir (Victrelis)
• Ceritinib (Zykadia)
• Cobicistat (Stribild)
• Conivaptan (Vaprisol)
• Cyclosporine (Neoral, etc.)
• Darunavir (Prezista)
• Delavirdine (Rescriptor)
• Diltiazem (Cardizem, etc.)
• Dronedarone (Multaq)
• Grapefruit
• Imatinib (Gleevec)
• Indinavir (Crixivan)
• Lapatinib (Tykerb)
• Lomitapide (Juxtapid)
• Mifepristone (Korlym)
• Nelfinavir (Viracept)
• Ritonavir (Norvir)
• Saquinavir (Invirase)
• Telaprevir (Incivek)
• Verapamil (Isoptin, etc.)

Comment:

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

Class 3: Assess Risk & Take Action if Necessary

• Consider Alternative: Use an alternative to the enzyme inhibitor if possible.
• Calcium channel blockers: Calcium channel blockers other than diltiazem and verapamil are unlikely to inhibit CYP3A4.
• Grapefruit: Orange juice does not appear to inhibit CYP3A4.
• Circumvent/Minimize: Consider reducing the dose of the antiviral if enzyme inhibitors are coadministered.
• Monitor:Monitor for antiviral toxicity.