Potential effects on drugs co-administered with ritonavir/Norvirtm

from the ritonavir/Norvirtm drug insert, Table 2

)
Drug
Category
Large1
increase -
CYP3A2
Moderate1
increase -
CYP2D62
Moderate1
increase or
decrease -
CYP2C9/192
Possible
increase -
unknown
CYP2
Possible
decrease -
glucuronidation2
Analgesics,
narcotic
alfentanil (Alfentatm)

fentanyl (Duragesic Transdermal Systemtm)

hydrocodone (Lorcettm, Lortabtm, Vicodintm; for pain and also severe coughing)

oxycodone (Percodantm)

tramadol



methadone (Dolophinetm) codeine (Tylenol #3tm, Empirintm, Tussi-Organidintm)

hydromorphone

morphine

Analgesics, nonsteroidal



diclofenac (Voltarentm)

ibuprofen (Adviltm, Motrintm)

indomethacin (Indocintm)

nabumetone

sulindac (Clinoriltm, Sulindactm)

ketoprofen (Orudistm)

ketorolac (Toradoltm)

naproxen (Naprosyntm, Alevetm)

Antiarrhythmics (acts to control or prevent cardiac arrhythmias [irregularity or loss of rhythm]) disopyramide

lidocaine

mexiletine (Mexitiltm, for neuropathy)

tocainide

digoxin



Antibiotic,

macrolide

erythromycin







Anticoagulant (blood thinners) R-warfarin

S-warfarin



Anticonvulsants carbamazepine (Tegretoltm, sometimes used for peripheral neuropathy)

clonazepam (Klonopintm, for seizures - including those from toxoplasmosis)

ethosuximide (Zarontintm)



phenytoin (Dilantintm) phenobarbital divalproex (Depakotetm)

lamotrigine (Lamictaltm)

Antihistamine loratidine (Claritintm)







Antidepressants, tricyclic

amitriptyline (Elaviltm)

clomipramine (Anafraniltm)

desipramine (Desipraminetm)

imipramine (Imipraminetm, Janiminetm, Tofraniltm)

maprotiline (Ludiomiltm



doxepin (Doxepintm, Sinequantm)

Antidepressants, other nefazodone (Serzonetm)

sertraline (Zolofttm)

trazodone (Desyreltm)

fluoxetine (Prozactm)

paroxetine (Paxiltm)

venlafaxine (Effexortm)



fluvoxamine (Luvoxtm)

Antidiarrheal







diphenoxylate (Lomotiltm)
Antiemetics (preventing or relieving nausea and vomiting) dronabinol (Marinoltm)

ondansetron (Zofrantm, for nausea)





prochlorperazine (Compazinetm, for nausea)

promethazine (Phenergantm, antihistamine/ antiemetic/ sedative)

metoclopramide (Clopratm, Reglantm)
Antifungal agents





itraconazole (Sporonoxtm)

ketoconazole (Nizoraltm)

miconazole (Monistattm)



Antihypertinsives



losartan doxazosin (Carduratm)

prazosin (Prazosintm, Minipresstm, Minizidetm)

terazosin (Hytrintm)



Antimycobacterial (Mycobacterium is a genus of organisms that includes what causes TB) rifampin (used in combination with other drugs for TB and MAC)







Antiparasitics (destroys parasites - organisms that live within, upon or at expense of another organism, known as the host) quinine

proguanil albendazole

chloroquine (Aralentm, Chloroquinetm)

metronidazole (Flagyltmantibiotic/ antiprotozoal/ antifungal. May work for microsporidiosis)

primaquine (Primaquinetm, for malaria)

pyrimethamine (Daraprimtm

atovaquone (Meprontm, for PCP, toxoplasmosis, microsporidiosis)
Antiulcer agents



lansoprazole

omeprazole (Prilosectm)

cimetidine (Tagamettm)

Beta blockers (substances that interfere with the transmission of stimuli...used in treating hypertension, heart problems, stage fright & benign tremors)

metoprolol (Lopressortm)

pindolol (Viskentm)

propranolol (Inderaltm, Inderidetm, can be used for anxiety)

timolol



acebutolol (Sectraltm)

betaxolol (Betoptictm, Kerlonetm)

penbutolol (Levatoltm)



Calcium channel blockers (act by slowing the influx of calcium into muscle cells, resulting in decreased oxygen demand by the heart -- treatment for angina hypertension) amlodipine

diltiazem (Cardizemtm)

felodipine (Plendiltm)

isradipine (DynaCirctm)

nicardipine (Cardenetm)

nifedipine (Adalattm, Nifedipinetm, Procardiatm









Cancer chemotherapeutic agents etoposide (VePesidtm, used in trials for KS, CMV)

paclitaxel (Taxoltm, trials for KS)

tamoxifen

vinblastine (Velbantm, for KS)

vincristine (Oncovintm, for KS)





cyclophosphamide (Cyclophosphamidetm, Cytoxantm, Neosartm)

daunorubicin (Cerubidinetm, liposomal form for KS)

doxorubicin (Adriamycintm, in combination with other drugs for KS; liposomal form DOX-SL



Corticosteroids dexamethasone (Decadrontm)

prednisone (used for, among other things, reducing lung inflammation in PCP)









Hemorrheologic agent





pentoxifylline (Trentaltm, possible immune-based anti-HIV therapy)

HIV protease inhibitors saquinavir (Invirasetm)







Hypoglycemics (pertaining to sugar deficiencies)



glipizide (Glucotroltm)

glyburide (DiaBetatm, Micronasetm)

tolbutamide (Orinasetm, Tolbutamidetm)





Hypolipidemics (decreasing the lipid [fat] concentration of the blood) lovastatin (Mevacortm)

pravastatin (Pravacholtm)





fluvastatin (Lescoltm)

gemfibrozil (Lopidtm)

simvastatin (Zocortm)

clofibrate (Atromid-Stm)
Immunosuppresants cyclosporine (Sandimmunetm)

tacrolimus









Neuroleptics ("an agent or drug that modifies psychotic behavior")

chlorpromazine (Chlorpromazinetm, Thorazinetm)

laloperidol

perphenazine (Trilafontm, psychoactive - antinausea, antivomiting, antipsychosis)

risperidone (Risperdaltm)

thioridazine (Mellariltm, Mellarzinetm







Sedative/hypnotics







lorazepam (Ativantm, psychoactive tranquilizer)

oxazepam (Seraxtm, for anxiety)

propofol

temazepam (Restoriltm, psychoactive sedative)

Stimulants

methamphetamine (Desoxyntm)

methylphenidate (Ritalintm, psychoactive stimulant)



1Large=> 3X. Moderate = 1.5X-3X

2Increased or decreased drug exposure (technically, the "area under the plasma concentration time curve," or "AUC") to this metabolizing agent. Increased AUC means that -- when on ritonavir -- there is more of this other drug in the blood. More drug in the blood means it is not being metabolized normally. This can lead to toxicities or increased side effects as a result. (Just the opposite can happen when there is decreased AUC: The drug may be being metabolized too quickly to be effective.)


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