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Table 3 Comparison of recommendation from drug interaction checkers for frequently occurring antiretroviral (ARV)- associated contraindicated and major potential drug-drug interactions

From: Prevalence and nature of potential drug-drug interactions among hospitalized HIV patients presenting with suspected meningitis in Uganda

Drug 1 Drug 2 Proposed effect summary – Micromedexa Scientific evidence; clinical significance – Liverpoolb Recommended adjustment- Liverpoolb
Atazanavir Fluconazole Increased atazanavir exposure and risk of QT interval prolongation Low; no interaction expected No prior dose adjustment necessary
Efavirenz Codeine Decreased opioid efficacy Very low; potential weak interaction No prior dose adjustment but monitor analgesic effect
Efavirenz Fluconazole Increased risk of QT interval prolongation Moderate; no interaction expected No dose adjustment necessary
Efavirenz Haloperidol Decrease in drug 2 exposure; QT interval prolongation Very low; potential weak interaction No prior dose adjustment is recommended
Efavirenz Metronidazole Increased risk of QT interval prolongation Very low; no interaction expected No dose adjustment necessary
Efavirenz Ondansetron Increased risk of QT interval prolongation Very low; no interaction expected No dose adjustment necessary
Efavirenz Rifampin Decrease in drug 1 serum concentration High; potential weak interaction No dose adjustment recommended in patients weighing < 50 kg
Ritonavir Fluconazole Increased ritonavir exposure and risk of QT interval prolongation Very low; no interaction expected No prior dose adjustment recommended
Tenofovir-DF Atazanavir Increase in drug 1 exposure and decrease in drug 2 exposure Moderate; do not co-administer Avoid co-administration, if necessary, monitor for adverse effects
Zidovudine Pyrazinamide Decrease drug 2 serum concentration Very low; no interaction expected No dose adjustment necessary
  1. aEffect summary from IBM Micromedex DRUGDEX® system
  2. bClinical recommendations as provided in the University of Liverpool HIV drug interaction website