Interaction entre Étravirine et Nirmatrelvir et ritonavir

…contraindicated with drugs that are primarily metabolized by CYP3A and for which elevated concentrations are associated with serious and/or life-threatening reactions and drugs that are strong CYP3A inducers where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance.

…Sedative/hypnotics: triazolam, oral midazolam • Serotonin receptor 1A agonist/serotonin receptor 2A antagonist: flibanserin • Vasopressin receptor antagonists: tolvaptan ➢ Drugs that are strong CYP3A inducers where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance.

PAXLOVID cannot be started immediately after discontinuation of any of the following medications due to the delayed offset of the recently discontinued CYP3A inducer [see Drug Interactions (7.3) ] : • Anticancer drugs: apalutamide, enzalutamide • Anticonvulsant: carbamazepine, phenobarbital, primidone, phenytoin • Antimycobacterials: rifampin, rifapentine • Cystic…

• Co-administration with potent CYP3A inducers where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance.

Medications that induce CYP3A may decrease concentrations of PAXLOVID.

HIV-antiviral agents: protease inhibitors (PIs) atazanavir (without ritonavir) ↓ atazanavir Co-administration of Etravirine and atazanavir without low-dose ritonavir is not recommended. atazanavir/ritonavir ↓ atazanavir ↔ etravirine Concomitant use of Etravirine with atazanavir/ritonavir decreased atazanavir C min but it is not considered clinically relevant.

Etravirine and atazanavir/ritonavir can be co-administered without dose adjustments. atazanavir/cobicistat ↓ atazanavir ↓ cobicistat Co-administration of Etravirine with atazanavir/cobicistat is not recommended because it may result in loss of therapeutic effect and development of resistance to atazanavir. darunavir/ritonavir ↓ etravirine The mean systemic exposure…

Because all subjects in the Phase 3 trials received darunavir/ritonavir as part of the background regimen and etravirine exposures from these trials were determined to be safe and effective, Etravirine and darunavir/ritonavir can be co-administered without dose adjustments. darunavir/cobicistat ↓ cobicistat darunavir: effect unknown Co-administration of Etravirine…

Co-administration of Etravirine and fosamprenavir without low-dose ritonavir is not recommended. fosamprenavir/ritonavir ↑ amprenavir Due to a significant increase in the systemic exposure of amprenavir, the appropriate doses of the combination of Etravirine and fosamprenavir/ritonavir have not been established.

Co-administration of Etravirine and fosamprenavir/ritonavir is not recommended. indinavir (without ritonavir) ↓ indinavir Concomitant use of Etravirine with indinavir without low-dose ritonavir may cause a significant alteration in the plasma concentration of indinavir.