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Guidelines for Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV [Internet]. Washington (DC): Pan American Health Organization; 2020 Apr.

Cover of Guidelines for Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV

Guidelines for Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV [Internet].

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ANNEX 7DRUG–DRUG INTERACTIONS: RIFAMYCINS OR ANTIFUNGAL DRUGS VERSUS ANTIRETROVIRAL DRUGS

Nucleoside reverse-transcriptase inhibitorsIntegrase strandtransfer inhibitorsNon-nucleoside reverse-transcriptase inhibitorsProtease inhibitors
TDFFTC3TCAZTABCDTGRALEFVNVPLPV/rATV/r
RifampicinNo interaction expectedNo interaction expectedNo interaction expectedPotential interaction: rifampicin reduces AZT levelsPotential weak interactionRifampicin reduces DTG levels; dose adjustment recommended.Rifampicin reduces RAL levels dose adjustment recommendedReduces EFV levels; no dose adjustment recommendedCoadministration is contraindicated due to decreased NVP concentrationsRifampicin decreases LPV/r levels. Dose adjustment possible but associated with toxicity.Coadministration is contraindicated. Rifampicin decreases ATV/r levels.
RifabutinNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedReduces rifabutin levels; increased rifabutin dose recommendedNVP increases rifabutin levels. Some people may experience toxicityLPV/r increases rifabutin levels. Reduced dose rifabutin and monitoring recommended.ATV/r increases rifabutin levels. Reduced dose rifabutin and monitoring recommended.
Amphotericin BPotential interaction: caution due to nephrotoxicityNo interaction expectedNo interaction expectedPotential interaction: monitor for toxicityNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expected
FluconazoleNo interaction expectedNo interaction expectedNo interaction expectedPotential interaction: monitor for toxicityNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedPotential interaction: FCN increases NVP levelsNo interaction expectedNo interaction expected
ItraconazolePotential interaction, but clinically significant effect unlikelyNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedNo interaction expectedReduces itraconazole levels; no dose recommendation can be made.Reduces itraconazole levels; dosing recommendations differIncreases itraconazole levelsIncreases itraconazole and ATV/r levels
Amphotericin BFluconazole
RifampicinNo interaction expectedRifampicin reduces levels of fluconazoleRifampicin leads to subtherapeutic levels of itraconazole
RifabutinNo interaction expectedFluconazole increases levels of rifabutin: monitoring recommendedRifabutin may decrease levels of itraconazole; itraconazole may increase levels of rifabutin; monitoring recommended.
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Bookshelf ID: NBK587201

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