Drug-drug Interactions

As management of renal impairment (RI) in people living with HIV includes many therapies also used for cardiovascular disease management, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin-II receptor antagonists, interactions of these therapies with highly active anti-retroviral therapy (HAART)/antiretroviral (ARV) therapies should be assessed using the HIV drug interactions website.

Drug-drug interactions have been observed between some angiotensin-II receptor antagonists and antiretrovirals (from the HIV drug interactions website):

  • Losartan and Irbesartan (angiotensin-II receptor antagonists): potential interactions with all PIs, NNRTIs, abacavir, zidovudine and maraviroc, but not with other NRTIs or raltegravir.

     

No clinically significant known or predicted interactions have been observed between:

  • ACE inhibitors (lisinopril, perindopril and ramipril) and protease inhibitors (PIs), non-nucleoside reverse-transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), maraviroc, or raltegravir
  • Candesartan (angiotensin-II receptor antagonist) and PIs, NNRTIs, NRTIs, maraviroc, or raltegravir.
     

For HIV-infected patients receiving ARV and other drugs, dosage reductions are often recommended in those with RI.1 For more information please see drug dosage adjustments in people living with HIV with RI, and refer to the prescribing information of individual medications.
 

References

  1. Rieke A. Clinical manifestation/diagnosis of nephropathy: HIV and Renal Function. Accessed 1 March 2011.