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Darunavir Tablets and Rifabutin

Determining the interaction of Darunavir Tablets and Rifabutin and the possibility of their joint administration.

Check result:

Darunavir Tablets <> Rifabutin

Relevance: 17.05.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using rifabutin together with darunavir can alter the effects of both medications. This can cause your condition to worsen. Call your doctor immediately if you experience a fever, chills, muscle or bone pain, blurred vision, eye pain or redness, a headache, excessive tiredness or weakness, a sore throat, unusual bleeding or bruising, or yellow skin or eyes. You may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSE: Coadministration of rifabutin and darunavir/ritonavir is expected to increase the plasma concentrations of rifabutin and decrease the plasma concentrations of darunavir. The proposed mechanism involves ritonavir inhibition of rifabutin metabolism via CYP450 3A4 and, conversely, rifabutin induction of darunavir metabolism via the same isoenzyme. Although the interaction has not been studied specifically with darunavir/ritonavir, it has been observed with other protease inhibitors, resulting in increased systemic exposure (AUC) of rifabutin by 110% to 300% and that of its 25-O-desacetyl metabolite by 13- to 35-fold. Uveitis secondary to rifabutin toxicity has been reported in some cases. The effect of rifabutin on protease inhibitors may vary. Rifabutin had negligible effects on some protease inhibitors but reduced the AUC of others such as indinavir, nelfinavir, and saquinavir by 30% to nearly 50%.

MANAGEMENT: To minimize the risk of rifabutin toxicity including leukopenia, uveitis, arthralgias and skin discoloration, darunavir labeling recommends that rifabutin dosage be reduced to 150 mg every other day in patients treated with darunavir/ritonavir. A complete blood count should be performed at least weekly and as clinically indicated to monitor for development of neutropenia.

References

"Product Information. Aptivus (tipranavir)." Boehringer-Ingelheim, Ridgefield, CT.
American Thoracic Society, CDC, Infectious Diseases Society of America "Treatment of tuberculosis." MMWR Morb Mortal Wkly Rep 52(RR-11) (2003): 1-77
Moyle GJ, Buss NE, Goggin T, Snell P, Higgs C, Hawkins DA "Interaction between saquinavir soft-gel and rifabutin in patients infected with HIV." Br J Clin Pharmacol 54 (2002): 178-82
Burman WJ, Jones BE "Treatment of HIV-related tuberculosis in the era of effective antiretroviral therapy." Am J Respir Crit Care Med 164 (2001): 7-12
"Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline, Research Triangle Park, NC.
Fournier S, Deplus S, Janier M, Poinsignon Y, Decazes JM, Modai J "Anterior uveitis in 3 HIV-infected patients treated with antiprotease." Presse Med 27 (1998): 844-8
"Product Information. Fortovase (saquinavir)" Roche Laboratories, Nutley, NJ.
"Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb, Princeton, NJ.
"Product Information. Norvir (ritonavir)." Abbott Pharmaceutical, Abbott Park, IL.
Cato A, Cavanaugh J, Shi H, Hsu A, Leonard J, Granneman R "The effect of multiple doses of ritonavir on the pharmacokinetics of rifabutin." Clin Pharmacol Ther 63 (1998): 414-21
Hamzeh FM, Benson C, Gerber J, et al. "Steady-state pharmacokinetic interaction of modified-dose indinavir and rifabutin." Clin Pharmacol Ther 73 (2003): 159-69
"Product Information. Prezista (darunavir)." Ortho Biotech Inc, Bridgewater, NJ.
"Product Information. Agenerase (amprenavir)." Glaxo Wellcome, Research Triangle Pk, NC.
Gariano RF, Gooney EL "Uveitis following administration of the protease inhibitor indinavir to a patient with AIDS." Clin Infect Dis 24 (1997): 529
"Product Information. Crixivan (indinavir)." Merck & Co, Inc, West Point, PA.
"Notice to readers: updated guidelines for the use of rifabutin or rifampin for the treatment and prevention of tuberculosis among HIV-infected patients taking protease inhibitors or nonnucleoside reverse transcriptase inhibiotrs." MMWR Morb Mortal Wkly Rep 49 (2000): 185-9
"Product Information. Viracept (nelfinavir)." Agouron Pharma Inc, La Jolla, CA.
Polk RE, Brophy DF, Israel DS, Patron R, Sadler BM, Chittick GE, Symonds WT, Lou Y, Kristoff D, Stein DS "Pharmacokinetic interaction between amprenavir and rifabutin or rifampin in healthy males." Antimicrob Agents Chemother 45 (2001): 502-8

Darunavir Tablets

Generic Name: darunavir

Brand name: Prezista

Synonyms: Darunavir

What is Darunavir Tablets?

Rifabutin

Generic Name: rifabutin

Brand name: Mycobutin

Synonyms: n.a.

What is Rifabutin?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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