लैमिवुडिन और ज़िडोवुडिन के इंटरैक्शन

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) ] . (एंटेकाविर लेबल, बॉक्स्ड चेतावनी)

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. (एडेफोविर लेबल, बॉक्स्ड चेतावनी)

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. (एफाविरेंज़, लैमिवुडिन और टेनोफोविर लेबल, चेतावनियां और सावधानियां)

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. (एमट्रिसिटाबिन लेबल, चेतावनियां और सावधानियां)

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. (एमट्रिसिटाबिन, रिल्पिविरिन और टेनोफोविर लेबल, दवाओं के इंटरैक्शन)

GENVOYA should not be administered with other antiretroviral medications for treatment of HIV-1 infection. (एल्विटेग्राविर, कोबिसिस्टैट, एमट्रिसिटाबिन और टेनोफोविर लेबल, दवाओं के इंटरैक्शन)

Coadministration with other antiretroviral medications for PrEP is not recommended. (कैबोटेग्राविर लेबल, दवाओं के इंटरैक्शन)

Antiviral and antiretroviral drugs: Avoid concomitant use. (क्लैड्रिबिन लेबल, दवाओं के इंटरैक्शन)

…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… (लैमिवुडिन और ज़िडोवुडिन लेबल, दवाओं के इंटरैक्शन)

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. (ज़िडोवुडिन लेबल, बॉक्स्ड चेतावनी)

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. (टेनोफोविर लेबल, चेतावनियां और सावधानियां)

PREZCOBIX or PREZCOBIX PED is not recommended in combination with other antiretroviral drugs that require pharmacokinetic boosting. (डारुनाविर और कोबिसिस्टैट लेबल, चेतावनियां और सावधानियां)

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. (नेविरापिन लेबल, बॉक्स्ड चेतावनी)

Because BIXLENVO is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended ( 7.1 ) (बिक्टेग्राविर, एमट्रिसिटाबिन और टेनोफोविर एलाफेनामाइड लेबल, दवाओं के इंटरैक्शन)

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 ). (रिफाब्यूटिन लेबल, चेतावनियां)

…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… (रिफैम्पिसिन लेबल, दवाओं के इंटरैक्शन)

• Hepatic decompensation, some fatal, has occurred in HIV‑1/HCV co‑infected patients receiving combination antiretroviral therapy and interferon alfa with/without ribavirin. (लैमिवुडिन और ज़िडोवुडिन लेबल, चेतावनियां और सावधानियां)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (लेडिपासविर और सोफोसबुविर लेबल, दवाओं के इंटरैक्शन)

सेंट जॉन्स वॉर्ट HIV की कुछ दवाओं का खून में स्तर इतना घटा सकता है कि इलाज विफल हो जाए। (NCCIH, St. John's Wort)

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. (हाइड्रॉक्सीयूरिया लेबल, दवाओं के इंटरैक्शन)

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 )] . (एबाकाविर लेबल, दवाओं के इंटरैक्शन)

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… (एलक्साडोलिन लेबल, दवाओं के इंटरैक्शन)

• 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) ] . (एसोमेप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

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) ]. (ऑर्लिस्टैट लेबल, चेतावनियां और सावधानियां)

• 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 )]. (ओमेप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

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 )] . (ओमेप्राज़ोल और सोडियम बाइकार्बोनेट लेबल, दवाओं के इंटरैक्शन)

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 )] . (कैबोज़ैंटिनिब लेबल, दवाओं के इंटरैक्शन)

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. (क्लैरिथ्रोमाइसिन लेबल, दवाओं के इंटरैक्शन)

The influence of terbinafine on the pharmacokinetics of fluconazole, cotrimoxazole (trimethoprim and sulfamethoxazole), zidovudine or theophylline was not considered to be clinically significant. (टर्बिनाफिन लेबल, दवाओं के इंटरैक्शन)

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. (टेरिफ्लुनोमाइड लेबल, दवाओं के इंटरैक्शन)

Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with Depakote ER ( 7.2 ) (डाइवैल्प्रोएक्स (वैल्प्रोएट) लेबल, दवाओं के इंटरैक्शन)

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 . (डेक्सलैंसोप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

…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. (डोलुटेग्राविर लेबल, दवाओं के इंटरैक्शन)

• 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) ]. (नेप्रोक्सेन और एसोमेप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

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. (पाइरिमेथामिन लेबल, दवाओं के इंटरैक्शन)

• 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. (पैंटोप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

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) ]. (पोसाकोनाज़ोल लेबल, दवाओं के इंटरैक्शन)

(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. (फ्लुकोनाज़ोल लेबल, दवाओं के इंटरैक्शन)

Antiretrovirals: Patients who are on chronic buprenorphine treatment should have their dose monitored if NNRTIs are added to their treatment regimen. (ब्यूप्रेनॉर्फिन और नालोक्सोन लेबल, दवाओं के इंटरैक्शन)

Zidovudine Experimental evidence demonstrated that methadone increased the AUC of zidovudine which could result in toxic effects. (मेथाडोन लेबल, दवाओं के इंटरैक्शन)

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). (रिटोनाविर लेबल, चेतावनियां और सावधानियां)

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,… (रिफापेंटिन लेबल, दवाओं के इंटरैक्शन)

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. (रैबेप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

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. (लेफ्लुनोमाइड लेबल, दवाओं के इंटरैक्शन)

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. (लैंसोप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

…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… (वैलगैनसिक्लोविर लेबल, दवाओं के इंटरैक्शन)

Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with valproic acid oral solution (7.2) (वैल्प्रोइक एसिड लेबल, दवाओं के इंटरैक्शन)

…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,… (साइक्लोफॉस्फामाइड लेबल, दवाओं के इंटरैक्शन)

Zidovudine should either be temporarily discontinued or decreased by 50% when coadministered with probenecid on the day of cidofovir infusion. (सिडोफोविर लेबल, दवाओं के इंटरैक्शन)

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. (एट्राविरिन लेबल, चेतावनियां और सावधानियां)

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… (एफाविरेंज़ लेबल, चेतावनियां और सावधानियां)

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. (एमट्रिसिटाबिन और टेनोफोविर लेबल, चेतावनियां और सावधानियां)

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. (निर्माट्रेल्विर और रिटोनाविर लेबल, दवाओं के इंटरैक्शन)

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. (पेंटामिडिन लेबल, दवाओं के इंटरैक्शन)

Intervention: None Antiretrovirals: Non-nucleoside reverse transcriptase inhibitors (NNRTIs) Clinical Impact: Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are metabolized principally by CYP3A4. (ब्यूप्रेनॉर्फिन लेबल, दवाओं के इंटरैक्शन)

Nucleoside Reverse Transcriptase Inhibitors: abacavir zidovudine ↓ abacavir ↓ zidovudine The clinical significance of this potential interaction is unknown. (लोपिनाविर और रिटोनाविर लेबल, दवाओं के इंटरैक्शन)

Antiretrovirals: atazanavir lopinavir ↑ voxilaprevir Coadministration of VOSEVI with atazanavir- or lopinavir-containing regimens is not recommended. tipranavir/ritonavir ↓ sofosbuvir ↓ velpatasvir Coadministration is not recommended. (सोफोसबुविर और वेल्पाटासविर लेबल, दवाओं के इंटरैक्शन)

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). (हाइड्रोकॉर्टिसोन लेबल, दवाओं के इंटरैक्शन)

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) ] . (एटाज़ानाविर लेबल, दवाओं के इंटरैक्शन)

…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. (डारुनाविर लेबल, दवाओं के इंटरैक्शन)

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… (डोराविरिन लेबल, दवाओं के इंटरैक्शन)

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. (फैमसिक्लोविर लेबल, दवाओं के इंटरैक्शन)

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 )] . (मेजेस्ट्रोल लेबल, दवाओं के इंटरैक्शन)

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. (राल्टेग्राविर लेबल, दवाओं के इंटरैक्शन)

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. (रिल्पिविरिन लेबल, दवाओं के इंटरैक्शन)