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APTIVUS®(五)
thin Class that are
Contraindicated with APTIVUS
Co-administered with Ritonavir
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Clinical Comments: |
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Alpha 1-adrenoreceptor antagonist |
Alfuzosin |
Potentially increased alfuzosin concentrations can result in hypotension. |
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Antiarrhythmics |
Amiodarone, bepridil, flecainide, propafenone, quinidine |
Potential for serious and/or life-threatening reactions such as cardiac arrhythmias secondary to increases in plasma concentrations of antiarrhythmics. |
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Antimycobacterials |
Rifampin |
May lead to loss of virologic response and possible resistance to APTIVUS or to the class of protease inhibitors or other co-administered antiretroviral agents. |
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Ergot derivatives |
Dihydroergotamine, ergonovine, ergotamine, methylergonovine |
Potential for acute ergot toxicity characterized by peripheral vasospasm and ischemia of the extremities and other tissues. |
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GI motility agent |
Cisapride |
Potential for cardiac arrhythmias. |
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Herbal products |
St. John's wort (hypericum perforatum) |
May lead to loss of virologic response and possible resistance to APTIVUS or to the class of protease inhibitors. |
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HMG CoA reductase inhibitors |
Lovastatin, simvastatin |
Potential for myopathy including rhabdomyolysis. |
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Neuroleptic |
Pimozide |
Potential for cardiac arrhythmias. |
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PDE-5 inhibitors |
Sildenafil (Revatio) [for treatment of pulmonary arterial hypertension] |
A safe and effective dose has not been established when used with APTIVUS/ritonavir. There is increased potential for sildenafil-associated adverse events (which include visual disturbances, hypotension, prolonged erection, and syncope). |
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Sedatives/hypnotics |
Oral midazolam, triazolam |
Prolonged or increased sedation or respiratory depression. |
Due to the need for co-administration of APTIVUS with ritonavir, please refer to the ritonavir prescribing information for a description of ritonavir contraindications.
5 WARNINGS AND PRECAUTIONS
Please refer to the ritonavir prescribing information for additional information on precautionary measures.
5.1 Hepatic Impairment and Toxicity
Clinical hepatitis and hepatic decompensation, including some fatalities, were reported with APTIVUS co-administered with 200 mg of ritonavir. These have generally occurred in patients with advanced HIV-1 disease taking multiple concomitant medications. A causal relationship to APTIVUS/ritonavir could not be established. Physicians and patients should be vigilant for the appearance of signs or symptoms of hepatitis, such as fatigue, malaise, anorexia, nausea, jaundice, bilirubinuria, acholic stools, liver tenderness or hepatomegaly. Patients with signs or symptoms of clinical hepatitis should discontinue APTIVUS/ritonavir treatment and seek medical eva luation.
All patients should be followed closely with clinical and laboratory monitoring, especially those with chronic hepatitis B or C co-infection, as |
