Drug Interactions Chart
An abbreviated, at-a-glance guide to HIV drug interactions
Updated by Paul Djuricich, R.Ph., Pharm.D.
and Enid Vázquez
Please see the drug’s page for details, or refer to the manufacturer’s package insert for a full comprehensive list of potential drug interactions. Also, make your pharmacist and health care providers aware of any drug that you add. Some interactions are more serious than others; some drugs may only require a dose adjustment, while others may either render the drug completely ineffective, or worse, lead to a potentially fatal reaction. Discuss any changes, however minor, with your health care providers, including your pharmacist, since small reactions may become serious. Look up your drugs with “Check my meds” at www.aidsmeds.com, which lists the effect of food as well as interactions for medications. The University of Liverpool also has an interactive database that allows you to look up antiretroviral drug interactions and has PDF charts of interactions between antiretrovirals and other drugs. Remember, brand names are usually capitalized, while generic names are not. Visit www.hiv-druginteractions.org.
| Nucleoside Reverse Transcriptase Inhibitors (also called nucleoside analogs, NRTIs, or nukes) | |
 Potential drug class interactions |
None. |
| Combivir (Retrovir and Epivir) |
See Epivir and zidovudine (Retrovir). Do not take zidovudine, Epivir, Epivir-HBV, Epzicom, Trizivir, Emtriva, Truvada, or Atripla while taking Combivir, since all or part of these medications are already in Combivir or have equivalent medications. |
| Emtriva (emtricitabine, or FTC) |
No significant drug interactions. Do not take Truvada, Atripla, Epivir, Epivir-HBV, Epzicom, Combivir, or Trizivir while taking Emtriva, since they contain Emtriva or medication equivalent to it. |
| Epivir (lamivudine, or 3TC) |
No significant drug interactions. Do not take Epivir-HBV, Epzicom, Combivir, Trizivir, Truvada, or Atripla while taking Epivir, since they contain Epivir or medication equivalent to it. |
| Epzicom (Epivir and Ziagen) |
See Epivir and Ziagen. Do not take Combivir, Epivir, Epivir-HBV, Trizivir, Emtriva, Truvada, or Atripla while taking Epzicom, since all or part of these medications are already in Epzicom or have equivalent medications. |
| Retrovir (zidovudine, or AZT) |
Do not take with Combivir or Trizivir, since zidovudine is already in these medications. Amphotericin B, Benemid, Biaxin, dapsone, Depakote, doxorubicin, flucytosine, ganciclovir, hydroxyurea, interferon-alpha, Mycobutin, pentamidine, phenytoin (Dilantin and others), ribavirin, rifampin, sulfadiazine, Valcyte, and Zerit. |
| Trizivir (Epivir, Retrovir, and Ziagen) |
See Epivir, Retrovir, and Ziagen. Do not take zidovudine (Retrovir), Epivir, Epivir-HBV, Ziagen, Emtriva, Truvada, or Atripla while taking Trizivir, since all or part of these medications are already in Trizivir or have equivalent medications. |
| Truvada (Viread and Emtriva) |
See Emtriva and Viread. Do not take with Emtriva, Viread, Atripla, Epivir, Epivir-HBV, Combivir, Epzicom, or Trizivir, since all or part of these medications are already in Truvada or have equivalent medications. |
| Videx & Videx EC (didanosine, or ddI) |
Alcohol, cimetidine, dapsone, ganciclovir, HIV protease inhibitors, hydroxyurea, itraconazole, ketoconazole, methadone, pentamidine, Rescriptor, Retrovir, ribavirin, Viread, and Zerit. |
| Viread (tenofovir) |
Do not take with Truvada or Atripla, since Viread is in these medications. Hepsera, Kaletra, Norvir, Reyataz, Videx and Videx-EC. |
| Zerit (stavudine, or d4T) |
Amphotericin B, dapsone, foscarnet, ganciclovir, pentamidine, Valcyte, Videx and Videx-EC, and zidovudine (AZT, Retrovir). |
| Ziagen (abacavir sulfate) | Do not take with Epzicom or Trizivir, since Ziagen is already in these medications. Alcohol. |
| Non-Nucleoside Reverse Transcriptase Inhibitors (also called non-nucleoside analogs, NNRTIs, or non-nukes) | |
| Potential drug class interactions |
HIV protease inhibitors; methadone. |
| Intelence (etravirine, or TMC-125) |
Aptivus/Norvir, Kaletra, Lexiva/Norvir, Norvir, Reyataz/Norvir, Selzentry, Sustiva, Viramune, and unboosted (without Norvir, or in rare cases, Rescriptor) PIs. |
| Rescriptor
(delavirdine) |
Agenerase, amlodipine, certain amphetamines and antiarrhythmic drugs, Biaxin, birth control pills, carbamazepine (Tegretol and others), Cialis, Crixivan, dapsone, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), felodipine, fluticasone (Advair, Flonase, Flovent), immunosuppressants, Invirase, Kaletra, Levitra, Lexiva, methadone, lovastatin, midazolam, Mycobutin, nifedipine, Norvir, phenobarbital, phenytoin (Dilantin and others), pimozide, Propulsid, quinidine, Reyataz, rifampin, simvastatin, St. John’s wort, trazodone, triazolam, Viagra, Viracept, Vytorin, warfarin, and Xanax (alprazolam). |
| Sustiva (efavirenz) |
Do not take with Atripla, since Sustiva is already in Atripla. Bepridil, Biaxin, birth control pills, carbamazepine (Tegretol and others), Crixivan, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), Invirase, itraconazole, Kaletra, Lexiva, Lipitor, methadone, midazolam, Mycobutin, Norvir, Reyataz, rifampin, phenobarbital, phenytoin (Dilantin and others), pravastatin, simvastatin, St. John’s wort, triazolam, Vfend, and warfarin. |
| Viramune (nevirapine) |
Biaxin, birth control pills, calcium channel blockers (Adalat, Norvasc, Procardia, and others), carbamazepine (Tegretol and others), clonazepam, Cordarone, disopyramide, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), ethosuxomide, flucanozole, HIV protease inhibitors, immunosuppressants, Kaletra, ketoconazole, lidocaine, methadone, midazolam, Mycobutin, prednisone, rifampin, St. John’s wort, triazolam, and warfarin. |
| Dual-class Fixed Dose Combination | |
| Atripla (Sustiva/Truvada) |
See Sustiva and Truvada (Emtriva/Viread). Do not take Sustiva, Emtriva, Truvada, Viread, Epivir, Epzicom, Combivir, or Trizivir, while taking Atripla, since all or part of these medications are already in Atripla or have equivalent medications. |
| Protease inhibitors (PIs) | |
| Potential drug class interactions |
Cardiac medications, cholesterol medication, migraine medications, erectile dysfunction drugs, sedatives, and tuberculosis drugs. |
| Aptivus (tipranavir) (must be taken with Norvir) |
Aptivus/Norvir interacts with many other drugs, so it is important to tell your health care professional all the medications you are taking. See the manufacturer package insert for the most complete list. Birth control pills, calcium channel blockers (Adalat, Norvasc, Procardia, and others), carbamazepine (Tegretol and others), Cialis, Crestor, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), disulfirum (Antabuse), Flagyl, fluconazole, fluticasone (Advair, Flonase, Flovent), other HIV protease inhibitors, immunosuppressants, itraconazole, ketoconazole, Lescol, Levitra, Lipitor, lovastatin, methadone, midazolam (oral), Mycobutin, Paxil, phenobarbital, phenytoin (Dilantin and others), pimozide, pravastatin, quinidine, rifampin, Rythmol, simvastatin, St. John’s wort, Tambocor, trazodone, triazolam, valproic acid, Viagra, vitamin E, Vfend, Videx, warfarin, Ziagen, zidovudine, and Zoloft. |
| Crixivan (indinavir sulfate) |
Birth control pills, calcium channel blockers (Adalat, Norvasc, Procardia, and others), carbamazepine (Tegretol and others), Cialis, coffee or alcohol (and other diuretics), Cordarone, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), fluticasone (Advair, Flonase, Flovent), garlic supplements, grapefruit juice, itraconazole, immunosuppressants, ketoconazole, Lescol, Levitra, Lipitor, lovastatin, methadone, midazolam, Mycobutin, phenytoin (Dilantin and others), phenobarbitol, pimozide, pravastatin, Rescriptor, Reyataz, rifampin, Rythmol, simvastatin, St. John’s wort, Sustiva, Tambocor, trazodone, triazolam, warfarin, Viagra, Viramune, and Vytorin. See drug page for more interactions. |
| Invirase (saquinavir) (must be taken with Norvir) |
Aptivus/Norvir, Biaxin, birth control pills, Cialis, Cordarone, Crestol, Crixivan, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), dapsone, fluticasone (Advair, Flonase, Flovent), garlic supplements, Kaletra, Lanoxin, Lescol, Levitra, Lipitor, lovastatin, methadone, midazolam, Mycobutin, Nizoral, Norvir, pimozide, pravastatin, quindine, rifampin, Rescriptor, Reyataz, Rythmol, simvastatin, St. John’s wort, Sporanox, Sustiva, Tambocor, trazodone, triazolam, Viracept, Viagra, Viramune, and Vytorin. |
| Kaletra (lopinavir/ritonavir) |
Biaxin, birth control pills, carbamazepine (Tegretol and others), certain calcium channel blockers, Cialis, Cordarone, digoxin, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), Flagyl, fluticasone (Advair, Flonase, Flovent), garlic supplements, immunosuppressants, itraconazole, Lescol, Levitra, Lexiva, Lipitor, lovastatin, Mepron, methadone, midazolam, Mycobutin, nifedipine, pimozide, phenobarbital, phenytoin (Dilantin and others), pravastatin, rifampin, Retrovir, Rythmol, simvastatin, St. John’s wort, steroids (especially Decadron), Sustiva, trazodone, triazolam, Uroxatral, Viagra, Videx, Viramune, Vytorin, warfarin, and Ziagen. |
| Lexiva (fos-amprenavir calcium) |
Birth control pills, certain calcium channel blockers, Cialis, Crestor, disulfirum (Antabuse), ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), Flagyl, fluticasone (Advair, Flonase, Flovent), Kaletra, Lipitor, Lescol, Levitra, lovastatin, pimozide, pravastatin, Rescriptor, Rythmol, methadone, midazolam, Mycobutin, rifampin, simvastatin, St. John’s wort, steroids (especially Decadron), Sustiva, Tambocor, trazodone, triazolam, Viagra, and warfarin. |
| Norvir (ritonavir) |
See the manufacturer package insert for the most complete list. Alcohol, Biaxin, birth control pills, Cialis, Cordarone, disulfiram (Antabuse), Ecstasy, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), Flagyl, fluticasone (Advair, Flonase, Flovent), garlic supplements, GHB, immunosuppressants, Lescol, Levitra, Lipitor, lovastatin, midazolam, pimozide, pravastatin, rifampin, Rythmol, simvastatin, St. John’s wort, Tambocor, tobacco, trazodone, triazolam, Uroxatral, and Viagra. |
| Prezista (darunavir) |
Altoprev, Advicor, Biaxin, birth control pills, calcium channel blockers (Norvasc, Procardia, and others), carbamazepine, Cialis, Cisapride, Crestor, ergot alkaloids (Cafergot, D.H.E. 45, Ergomar, ergonovine, methylergonovine, Migranal), fluticasone (Advair, Flonase, and Flovent), immunosuppressants, Invirase, itraconazole, Kaletra, ketoconazole, Levitra, Lipitor, lovastatin, methadone, Mevacor, midazolam (oral), nifedipine, Paxil, pimozide, phenobarbital, phenytoin, pravastatin, rifabutin, rifampin, Simcor, simvastatin, St. John’s wort, trazodone, triazolam, Vfend, Viagra, Vytorin, warfarin, and Zoloft. |
| Reyataz (atazanavir sulfate) |
Antacids (including Axid, Rolaids, Tums, Mylanta, Pepcid, and Zantac), bepridil, birth control pills, calcium channel blockers (Adalat, Norvasc, Procardia, and others), Cialis, Crixivan, Camptosar, Crestor, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), fluticasone (Advair, Flonase, Flovent), garlic supplements, immunosuppressants, itraconazole, ketoconazole, Lescol, Levitra, lidocaine, Lipitor, lovastatin, midazolam (oral), Mylanta, phenytoin (Dilantin and others), pimozide, pravastatin, proton-pump inhibitors (Aciphex, Nexium, Prevacid, Prilosec-OTC), quinidine, rifabutin, rifampin, simvastatin, St. John’s wort, Sustiva, trazodone, triazolam, tricyclic antidepressants, Vfend, Viagra, Videx and Videx-EC, Viread, Vytorin, and warfarin. See drug page for more. |
| Viracept (nelfinavir) |
Birth control pills, carbamazepine (Tegretol and others), Cialis, Cordarone, Crixivan, ergot alkaloids (Cafergot, D.H.E. 45, Methergine, Wigraine), fluticasone (Advair, Flonase, Flovent), garlic supplements, Invirase, Lescol, Levitra, Lipitor, lovastatin, methadone, midazolam, Mycobutin, phenobarbital, phenytoin (Dilantin and others), pravastatin, Prilosec-OTC, rifampin, simvastatin, St. John’s wort, triazolam, trazodone, Viagra and Vytorin. |
| Entry Inhibitors | |
| Fuzeon (enfuvirtide, or T-20) |
None found to be clinically significant. |
| Selzentry (maraviroc) | Invirase, Kaletra, ketoconazole, Norvir, Reyataz, rifampin, and Sustiva. |
| Integrase Inhibitor | |
| Isentress (raltegravir) |
Aptivus/Norvir, Epivir, medications that can cause muscle problems, Reyataz, Reyataz/Norvir, rifampin, and Viread. |
