Prezista Drug Interactions

Potential for PREZISTA/ritonavir to Affect Other Drugs: PREZISTA co-administered with ritonavir is an inhibitor of CYP3A, CYP2D6, and P‑gp. Co‑administration of PREZISTA and ritonavir with drugs that are primarily metabolized by CYP3A and CYP2D6 or are transported by P‑gp may result in increased plasma concentrations of such drugs, which could increase or prolong their therapeutic effect and adverse events. PREZISTA co-administered with ritonavir with drugs that have active metabolite(s) formed by CYP3A may result in reduced plasma concentrations of these active metabolite(s), potentially leading to loss of their therapeutic effect (see Table 22).
Potential for Other Drugs to Affect Darunavir: Darunavir and ritonavir are metabolized by CYP3A. In vitro data indicate that darunavir may be a P‑gp substrate. Drugs that induce CYP3A activity would be expected to increase the clearance of darunavir and ritonavir, resulting in lowered plasma concentrations of darunavir and ritonavir. Co‑administration of darunavir and ritonavir and other drugs that inhibit CYP3A, or P-gp may decrease the clearance of darunavir and ritonavir and may result in increased plasma concentrations of darunavir and ritonavir (see Table 22).
Established and Other Potentially Significant Drug Interactions: Table 22 provides dosing recommendations as a result of drug interactions with PREZISTA/ritonavir. These recommendations are based on either drug interaction studies or predicted interactions due to the expected magnitude of interaction and potential for serious adverse events or loss of efficacy. The table includes potentially significant interactions but is not all inclusive [see Contraindications and Pharmacology: Pharmacokinetics under Actions]. (See Table 22.)

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Drugs without Clinically Significant Interactions with PREZISTA: No dosage adjustments are recommended when 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.