Key Pharmacologic Principles and Drug-Drug Interactions in HIV Patient Care
Summary
- Alfuzosin and silodosin are contraindicated for use in patients receiving strong CYP 3A4 inhibitors, such as ritonavir and cobicistat, and therefore should not be used with ritonavir-boosted or cobicistat-boosted PIs, cobicistat/elvitegravir/emtricitabine/tenofovir DF, or cobicistat/elvitegravir/emtricitabine/tenofovir AF[FDA Alfuzosin; FDA COBI/EVG/TDF/FTC; FDA COBI/EVG/TAF/FTC; FDA Atazanavir/Cobicistat; FDA Darunavir/Cobicistat]
- Patients receiving ritonavir-boosted PIs or cobicistat with doxazosin, terazosin, and tamsulosin may have higher concentrations of anti-hypertensive agents and should be closely monitoring for hypotensive effects
- Patients on NNRTIs will require monitoring and potentially dose adjustments with these anti-hypertensive agents
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