Antiretroviral Guidelines

US DHHS Guidelines with Australian commentary

Drug Interactions between Non-Nucleoside Reverse Transcriptase Inhibitors and Other Drugs

Last Updated: October 25, 2018; Last Reviewed: October 25, 2018

This table provides information relating to PK interactions between NNRTIs and non-ARV drugs. For interactions between ARV agents and for dosing recommendations, refer to Tables 19c, 20a, and 20b. Recommendations for managing a particular drug interaction may differ depending on whether a new ARV drug is being initiated in a patient on a stable concomitant medication or if a new concomitant medication is being initiated in a patient on a stable ARV regimen. The magnitude and significance of drug interactions are difficult to predict when several drugs with competing metabolic pathways are prescribed concomitantly.

Note: DLV is not included in this table. Please refer to the DLV FDA package insert for information regarding drug interactions. The term “All NNRTIs” in this table refers to all NNRTIs except for DLV.

a Approved dose for RPV is 25 mg once daily. Most PK interaction studies were performed using 75 to 150 mg per dose.
b Norbuprenorphine is an active metabolite of buprenorphine.
c R-methadone is the active form of methadone.

Key to Symbols: 
↑ = increase 
↓ = decrease 
↔ = no change

Key to Acronyms: ARV = antiretroviral; AUC = area under the curve; BID = twice daily; CCB = calcium channel blocker; Cmax = maximum plasma concentration; Cmin = minimum plasma concentration; DAA = direct-acting antiviral; DHA = dihydroartemisinin; DMPA = depot medroxyprogesterone acetate; DOR = doravirine; EFV = efavirenz; ETR = etravirine; HMG-CoA = hydroxy-methylglutaryl-coenzyme A; INR = international normalized ratio; MAC = Mycobacterium avium complex; NNRTI = non-nucleoside reverse transcriptase inhibitor; NVP = nevirapine; OH-itraconazole = active metabolite of itraconazole; PCP = Pneumocystis jirovecii pneumonia; PDE5 = phosphodiesterase type 5; PI = protease inhibitor; PI/r = protease inhibitor/ritonavir; PK = pharmacokinetic; PPI = proton pump inhibitor; RPV = rilpivirine; RTV = ritonavir