Mechanisms of pharmacokinetic drug interactions between antiretrovirals and medications commonly used in older adults
Mechanism | Relevant antiretrovirals | Coadministered agents | Possible management strategy |
---|---|---|---|
Absorption | |||
Gastric acidity |
| Antacids | Separate administration times by at least 2 h (26), (27) |
H2-receptor antagonists |
| ||
Proton pump inhibitors | Avoid concomitant use | ||
Chelation |
| Antacids | Separate administration times by at least 2 h (28)– (30) |
Metabolism | |||
CYP450 3A4 |
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Other CYP450 isoenzymes (e.g., CYP2D6, CYP2B6, CYP2C9, CYP2C19) |
|
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Note: CYP450 = cytochrome P450, NNRTI = non-nucleoside reverse transcriptase inhibitor.