Wechselwirkungen von Lamivudin und Zidovudin

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs alone or in combination with other antiretrovirals [See Warnings and Precautions (5. (Fachinformation zu Adefovir, Boxed Warning (umrahmter Warnhinweis))

Because BIXLENVO is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended ( 7.1 ) (Fachinformation zu Bictegravir, Emtricitabin und Tenofoviralafenamid, Arzneimittelwechselwirkungen)

Coadministration with other antiretroviral medications for PrEP is not recommended. (Fachinformation zu Cabotegravir, Arzneimittelwechselwirkungen)

Antiviral and antiretroviral drugs: Avoid concomitant use. (Fachinformation zu Cladribin, Arzneimittelwechselwirkungen)

PREZCOBIX or PREZCOBIX PED is not recommended in combination with other antiretroviral drugs that require pharmacokinetic boosting. (Fachinformation zu Darunavir und Cobicistat, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

GENVOYA should not be administered with other antiretroviral medications for treatment of HIV-1 infection. (Fachinformation zu Elvitegravir, Cobicistat, Emtricitabin und Tenofovir, Arzneimittelwechselwirkungen)

Lactic Acidosis/Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs, including FTC, alone or in combination with other antiretrovirals. (Fachinformation zu Emtricitabin, Warnhinweise und Vorsichtsmaßnahmen)

COMPLERA is a complete regimen for the treatment of HIV-1 infection; therefore, coadministration with other antiretroviral medications for treatment of HIV-1 infection is not recommended. (Fachinformation zu Emtricitabin, Rilpivirin und Tenofovir, Arzneimittelwechselwirkungen)

Therapy with BARACLUDE is not recommended for HIV/HBV co-infected patients who are not also receiving highly active antiretroviral therapy (HAART) [see Warnings and Precautions (5.2) ] . (Fachinformation zu Entecavir, Boxed Warning (umrahmter Warnhinweis))

…Nucleoside analogues, e.g., ribavirin Hematologic/Bone Marrow Suppressive/Cytotoxic Agents Coadministration with the following drugs may increase the hematologic toxicity of zidovudine: • Ganciclovir • Interferon alfa • Ribavirin • Other bone marrow suppressive or cytotoxic agents 7.2 Lamivudine Sorbitol Coadministration of single doses of lamivudine and sorbitol resulted… (Fachinformation zu Lamivudin und Zidovudin, Arzneimittelwechselwirkungen)

Increased Toxicity with Concomitant Use of Antiretroviral Drugs Pancreatitis Pancreatitis (including fatal cases) have occurred in patients with HIV infection during therapy with hydroxyurea and didanosine, with or without stavudine. (Fachinformation zu Hydroxycarbamid, Arzneimittelwechselwirkungen)

Johanniskraut kann die Blutspiegel einiger HIV-Arzneimittel so stark senken, dass die Behandlung versagt. (NCCIH, St. John's Wort)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Female gender and higher CD4 + cell counts at initiation of therapy place patients at increased risk; women with CD4 + cell counts greater than 250 cells/mm 3 , including pregnant women receiving nevirapine in combination with other antiretrovirals for the treatment of HIV-1 infection, are at the greatest risk. (Fachinformation zu Nevirapin, Boxed Warning (umrahmter Warnhinweis))

• Hepatic decompensation, some fatal, has occurred in HIV‑1/HCV co‑infected patients receiving combination antiretroviral therapy and interferon alfa with/without ribavirin. (Fachinformation zu Lamivudin und Zidovudin, Warnhinweise und Vorsichtsmaßnahmen)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (Fachinformation zu Rifabutin, Warnhinweise)

…Concentrations Administered with rifampin 600 mg daily, unless otherwise specified AUC = area under the time-concentration curve Drug or Drug Class and Prevention or Management Clinical Effect Antiretrovirals Prevention or Management: Concomitant use is contraindicated (see CONTRAINDICATIONS ) Atazanavir Decrease AUC by 72% Darunavir Rifampin dosage used concomitantly with… (Fachinformation zu Rifampicin, Arzneimittelwechselwirkungen)

Lactic Acidosis/Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs, including TDF, alone or in combination with other antiretrovirals. (Fachinformation zu Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including zidovudine and other antiretrovirals. (Fachinformation zu Zidovudin, Boxed Warning (umrahmter Warnhinweis))

Riociguat Coadministration with fixed-dose abacavir/dolutegravir/lamivudine resulted in increased riociguat exposure, which may increase the risk of riociguat adverse reactions [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Abacavir, Arzneimittelwechselwirkungen)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (Fachinformation zu Buprenorphin und Naloxon, Arzneimittelwechselwirkungen)

Monitor patients for increased toxicity when MRP2 inhibitors (e.g., abacavir, adefovir, cidofovir, furosemide, lamivudine, nevirapine, ritonavir, probenecid, saquinavir, and tenofovir) are co-administered with COMETRIQ [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Cabozantinib, Arzneimittelwechselwirkungen)

Zidovudine should either be temporarily discontinued or decreased by 50% when coadministered with probenecid on the day of cidofovir infusion. (Fachinformation zu Cidofovir, Arzneimittelwechselwirkungen)

Zidovudine Zidovudine: Simultaneous oral administration of clarithromycin immediate-release tablets and zidovudine to HIV-infected adult patients may result in decreased steady-state zidovudine concentrations. (Fachinformation zu Clarithromycin, Arzneimittelwechselwirkungen)

…can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone ● G-CSF,… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with dexlansoprazole may reduce antiviral effect and promote the development of drug resistance . (Fachinformation zu Dexlansoprazol, Arzneimittelwechselwirkungen)

…dolutegravir exposures observed in INSTI-experienced patients (with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance [see Microbiology ( 12.4 )] ) upon coadministration with certain inducers may result in loss of therapeutic effect and development of resistance to TIVICAY or other coadministered antiretroviral agents. (Fachinformation zu Dolutegravir, Arzneimittelwechselwirkungen)

Examples: cyclosporine, gemfibrozil, antiretrovirals (atazanavir, lopinavir, ritonavir, saquinavir, tipranavir), rifampin, eltrombopag Drugs that Cause Constipation Clinical Impact: Increased risk for constipation related adverse reactions and potential for constipation related serious adverse reactions Intervention: Avoid use with other drugs that may cause… (Fachinformation zu Eluxadolin, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine atazanavir, and nelfinavir) when used concomitantly with esomeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Esomeprazol, Arzneimittelwechselwirkungen)

(See CLINICAL PHARMACOLOGY: Drug Interaction Studies . ) Zidovudine Fluconazole increases the C max and AUC of zidovudine by 84% and 74%, respectively, due to an approximately 45% decrease in oral zidovudine clearance. (Fachinformation zu Fluconazol, Arzneimittelwechselwirkungen)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with lansoprazole may reduce antiviral effect and promote the development of drug resistance. (Fachinformation zu Lansoprazol, Arzneimittelwechselwirkungen)

In patients taking ARAVA, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Fachinformation zu Leflunomid, Arzneimittelwechselwirkungen)

Zidovudine Experimental evidence demonstrated that methadone increased the AUC of zidovudine which could result in toxic effects. (Fachinformation zu Methadon, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )]. (Fachinformation zu Omeprazol, Arzneimittelwechselwirkungen)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Omeprazol und Natriumhydrogencarbonat, Arzneimittelwechselwirkungen)

Drug Interactions and Decreased Vitamin Absorption ORLISTAT may interact with concomitant drugs including cyclosporine, levothyroxine, warfarin, amiodarone, antiepileptic drugs, and antiretroviral drugs [see Drug Interactions (7) ]. (Fachinformation zu Orlistat, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine atazanavir, and nelfinavir) when used concomitantly with pantoprazole may reduce antiviral effect and promote the development of drug resistance. (Fachinformation zu Pantoprazol, Arzneimittelwechselwirkungen)

Anti-HIV Drugs that are CYP3A4 Substrates Mechanism and Clinical Effect(s) Ritonavir and atazanavir are CYP3A4 substrates and posaconazole increased plasma concentrations of these drugs [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Posaconazol, Arzneimittelwechselwirkungen)

However, the concomitant use of other antifolic drugs or agents associated with myelosuppression including sulfonamides or trimethoprim- sulfamethoxazole combinations, proguanil, zidovudine, or cytostatic agents (e.g., methotrexate), while the patient is receiving pyrimethamine, may increase the risk of bone marrow suppression. (Fachinformation zu Pyrimethamin, Arzneimittelwechselwirkungen)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with rabeprazole may reduce antiviral effect and promote the development of drug resistance. (Fachinformation zu Rabeprazol, Arzneimittelwechselwirkungen)

Fixed-Dose Combination of Efavirenz, Emtricitabine, and Tenofovir Once-weekly coadministration of 900 mg PRIFTIN with the antiretroviral fixed-dose combination of efavirenz 600 mg, emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg in HIV-infected patients did not result in any substantial change in steady state exposures of efavirenz, emtricitabine,… (Fachinformation zu Rifapentin, Arzneimittelwechselwirkungen)

Hepatotoxicity Hepatic transaminase elevations exceeding 5 times the upper limit of normal, clinical hepatitis, and jaundice have occurred in patients receiving NORVIR alone or in combination with other antiretroviral drugs (see Table 2). (Fachinformation zu Ritonavir, Warnhinweise und Vorsichtsmaßnahmen)

The influence of terbinafine on the pharmacokinetics of fluconazole, cotrimoxazole (trimethoprim and sulfamethoxazole), zidovudine or theophylline was not considered to be clinically significant. (Fachinformation zu Terbinafin, Arzneimittelwechselwirkungen)

In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Fachinformation zu Teriflunomid, Arzneimittelwechselwirkungen)

…myelosuppression or nephrotoxicity (e.g., adriamycin, dapsone, doxorubicin, flucytosine, hydroxyurea, pentamidine, tacrolimus, trimethoprim/ sulfamethoxazole, vinblastine, vincristine, and zidovudine) Unknown Because of potential for higher toxicity, coadministration with valganciclovir hydrochloride should be considered only if the potential benefits are judged to outweigh… (Fachinformation zu Valganciclovir, Arzneimittelwechselwirkungen)

Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with Depakote ER ( 7.2 ) (Fachinformation zu Valproat-Seminatrium (Divalproex), Arzneimittelwechselwirkungen)

Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with valproic acid oral solution (7.2) (Fachinformation zu Valproinsäure, Arzneimittelwechselwirkungen)

Intervention: None Antiretrovirals: Non-nucleoside reverse transcriptase inhibitors (NNRTIs) Clinical Impact: Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are metabolized principally by CYP3A4. (Fachinformation zu Buprenorphin, Arzneimittelwechselwirkungen)

Analysis of long-term data from Study 006 (median follow-up 180 weeks, 102 weeks, and 76 weeks for patients treated with efavirenz + zidovudine + lamivudine, efavirenz + indinavir, and indinavir + zidovudine + lamivudine, respectively) showed that, beyond 24 weeks of therapy, the incidences of new-onset nervous system symptoms among efavirenz-treated patients… (Fachinformation zu Efavirenz, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis/Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs, including emtricitabine, a component of DESCOVY, and tenofovir DF, another prodrug of tenofovir, alone or in combination with other antiretrovirals. (Fachinformation zu Emtricitabin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Stevens-Johnson syndrome was reported in 1.1% (2/177) of pediatric patients less than 18 years of age receiving Etravirine in combination with other HIV-1 antiretroviral agents in an observational study. (Fachinformation zu Etravirin, Warnhinweise und Vorsichtsmaßnahmen)

Examples: Anti-fungals: itraconazole, posaconazole, voriconazole Antibiotics: erythromycin and clarithromycin Antiretrovirals: ritonavir Grapefruit juice CYP3A4 Inducers Clinical Impact: Hydrocortisone is metabolized by cytochrome P450 3A4 (CYP3A4). (Fachinformation zu Hydrocortison, Arzneimittelwechselwirkungen)

Nucleoside Reverse Transcriptase Inhibitors: abacavir zidovudine ↓ abacavir ↓ zidovudine The clinical significance of this potential interaction is unknown. (Fachinformation zu Lopinavir und Ritonavir, Arzneimittelwechselwirkungen)

Anti-HIV efavirenz, maraviroc, nevirapine, zidovudine, bictegravir/ emtricitabine/ tenofovir ↑ efavirenz ↑ maraviroc ↑ nevirapine ↓ zidovudine ↑ bictegravir ↔ emtricitabine ↑ tenofovir For further information, refer to the respective anti-HIV drugs prescribing information. (Fachinformation zu Nirmatrelvir und Ritonavir, Arzneimittelwechselwirkungen)

Drug Interactions While specific studies on drug interactions with Pentamidine Isethionate have not been conducted, the majority of patients in clinical trials received concomitant medications, including zidovudine, with no reported interactions. (Fachinformation zu Pentamidin, Arzneimittelwechselwirkungen)

Antiretrovirals: atazanavir lopinavir ↑ voxilaprevir Coadministration of VOSEVI with atazanavir- or lopinavir-containing regimens is not recommended. tipranavir/ritonavir ↓ sofosbuvir ↓ velpatasvir Coadministration is not recommended. (Fachinformation zu Sofosbuvir und Velpatasvir, Arzneimittelwechselwirkungen)

Drugs with No Observed Interactions with REYATAZ No clinically significant drug interactions were observed when REYATAZ was coadministered with methadone, fluconazole, acetaminophen, atenolol, or the nucleoside reverse transcriptase inhibitors lamivudine or zidovudine [see Clinical Pharmacology, Tables 21 and 22 (12.3) ] . (Fachinformation zu Atazanavir, Arzneimittelwechselwirkungen)

…PREZISTA/ritonavir is co-administered with the following medications: atazanavir, dolutegravir, efavirenz, etravirine, nevirapine, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, emtricitabine/tenofovir alafenamide, lamivudine, stavudine, tenofovir disoproxil fumarate, zidovudine), pitavastatin, raltegravir, ranitidine, or rilpivirine. (Fachinformation zu Darunavir, Arzneimittelwechselwirkungen)

No clinically significant changes in concentration were observed for doravirine when co-administered with the following agents: dolutegravir, TDF, lamivudine, elbasvir and grazoprevir, ledipasvir and sofosbuvir, ritonavir, ketoconazole, aluminum hydroxide/magnesium hydroxide/simethicone containing antacid, pantoprazole, and methadone [see Clinical Pharmacology… (Fachinformation zu Doravirin, Arzneimittelwechselwirkungen)

No clinically significant effect on the pharmacokinetics of zidovudine, its metabolite zidovudine glucuronide, or emtricitabine was observed following a single oral dose of 500 mg famciclovir coadministered with zidovudine or emtricitabine. (Fachinformation zu Famciclovir, Arzneimittelwechselwirkungen)

Zidovudine and Rifabutin No dosage adjustment for zidovudine and rifabutin is needed when megestrol acetate is coadministered with these drugs [See Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Megestrol, Arzneimittelwechselwirkungen)

Drugs without Clinically Significant Interactions with ISENTRESS In drug interaction studies, raltegravir did not have a clinically meaningful effect on the pharmacokinetics of the following: hormonal contraceptives, methadone, lamivudine, tenofovir, etravirine, darunavir/ritonavir, or boceprevir. (Fachinformation zu Raltegravir, Arzneimittelwechselwirkungen)

No clinically relevant drug-drug interaction is expected when EDURANT or EDURANT PED is coadministered with maraviroc, ribavirin or the NRTIs abacavir, emtricitabine, lamivudine, stavudine and zidovudine. (Fachinformation zu Rilpivirin, Arzneimittelwechselwirkungen)