Interactions

Drug-Drug

• Etravirine is a substrate of the CYP3A4, CYP2C9, and CYP2C19 enzyme systems; other medications the induce or inhibit these systems may be expected to alter the response to etravirine. Etravirine is an inducer of CYP3A4 and an inhibitor of CYP2C9 and CYP2C19. The effects of medications that are substrates of these enzyme systems may be altered by concurrent use.

• Concurrent use with other NNRTIs including efavirenz, nevirapine, and delavirdine may lead to effectiveness and should be avoided.

• Concurrent use with protease inhibitors (PIs) including atazanavir, fosamprenavir, nelfinavir, and indinavir may lead to altered plasma levels and should be untertaken with concurrent low dose ritonavir.

• Concurrent use with higher dose ritonavir, combination tipranavir/ritonavir, fosamprenavir/ritonavir, atazanavir/ritonavir alter levels and effectiveness of etravirine and should be avoided.

• Concurrent use of the combination saquinavir/ritonavir should be undertake cautiously.

• blood levels and effectiveness of antiarrhythmics including amiodarone, bepridil, disopyramide, flecainide, lidocaine, mexiletine, quinidine, propafenone, and quinidine; blood level monitoring recommended.

• Blood levels and effects may be by anticonvulsants including carbamazepine, phenobarbital, and phenytoin.

• Concurrent use with voriconazole may levels of both drugs; levels of itraconazole and ketoconazole (dose adjustments may be necessary)

• May alter levels and response to clarithromycin; other agents should be considered

• Rifampin and rifapentine blood levels and effectiveness and should be avoided; rifabutin should only be used without a protease inhibitor/ritonavir combination.

• May blood levels and sedation from diazepam, monitor for effects.

• Levels and effectiveness may be by dexamethasone use cautiously and consider alternatives.

• May alter blood levels and effects of fluvastatin, lovastatin, and simvastatin (dose adjustments may be necessary.

• May alter blood levels and effects of cyclosporine, sirolimus, and tacrolimus; careful monitoring required.

Drug-Natural Products
St. John's wort may blood levels and effectiveness; avoid concurrent use

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