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Appendix xii

TABLE XII-1
SIGNIFICANT INTERACTIONS BETWEEN ANTIRETROVIRAL THERAPY AND
PSYCHOTROPIC MEDICATIONS: CONTRAINDICATED COMBINATIONS AND

AGENTS TO BE USED WITH CAUTION
Medication
Contraindicated
Use With Caution
Comments
levels may be significantly increased with • Monitor tricyclic antidepressant therapy closely for toxicity. concentrations due to induction of the CYP450 system. • Midazolam and triazolam levels may be significantly increased with concurrent PI • Midazolam and triazolam levels may be significantly increased with concurrent PI use. • Carbamazepine, phenobarbital, and rifampin may reduce PI drug concentrations due to induction of the CYP450 system. • Midazolam and triazolam levels may be • Midazolam and triazolam levels may be significantly increased with concurrent use; avoid combination. • Efavirenz may increase pimozide levels; monitor closely for toxicity. • Carbamazepine may reduce PI drug concentrations due to induction of the CYP450 system. drug concentrations due to induction of the CYP450 system; do not use. 12/07 New York State Department of Health AIDS Institute: http://www.hivguidelines.org 1 levels may be significantly increased with concurrent PI use. • Carbamazepine may reduce PI drug concentrations due to induction of the CYP450 system. levels may be significantly increased with concurrent PI use. • Lopinavir/ritonavir may reduce olanzapine levels. • Carbamazepine may reduce PI drug concentrations due to induction of the CYP450 system. increase maraviroc metabolism, leading to loss of virologic response, and possible resistance to maraviroc; consider increasing the dose of maraviroc to 600 mg twice daily. • Midazolam and triazolam levels may be significantly increased with concurrent PI use. • Carbamazepine may reduce PI drug concentrations due to induction of the CYP450 system. carbamazepine is unknown. Use with caution and consider monitoring carbamazepine levels. administration may significantly decrease raltegravir serum concentrations. levels may be significantly increased with • Due to the complex nature of ritonavir metabolism, increased or decreased levels psychotropic agents or adding ritonavir. • Monitor desipramine levels when used • Ritonavir may reduce olanzapine levels. trazadone, selective • Carbamazepine may reduce PI drug serotonin re-uptake 12/07 New York State Department of Health AIDS Institute: http://www.hivguidelines.org 2 • Midazolam and triazolam levels may be significantly increased with concurrent PI use. • Carbamazepine may reduce PI drug concentrations due to induction of the CYP450 system. • Midazolam and triazolam levels may be significantly increased with concurrent PI • Carbamazepine and phenobarbital may reduce PI drug concentrations due to induction of the CYP450 system. 12/07 New York State Department of Health AIDS Institute: http://www.hivguidelines.org 3

Source: http://www.hivguidelines.lfchosting.com/GuidelineDocuments/m-app2.pdf

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