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Delavirdine and Tegretol

Determining the interaction of Delavirdine and Tegretol and the possibility of their joint administration.

Check result:
Delavirdine <> Tegretol
Relevance: 27.06.2023 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:

CarBAMazepine can significantly reduce the blood levels of delavirdine, which may make the medication less effective in treating HIV infection. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. 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:

GENERALLY AVOID: Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of delavirdine, which is primarily metabolized by the isoenzyme. In seven HIV-infected subjects, administration of delavirdine (400 mg three times a day for 30 days) in combination with the potent CYP450 3A4 inducer rifampin (600 mg once daily on days 16 thru 30) decreased mean delavirdine peak plasma concentration (Cmax), systemic exposure (AUC) and trough plasma concentration (Cmin) by approximately 92%, 97% and 100%, respectively, compared to administration of delavirdine alone. Oral clearance of delavirdine also increased by nearly 27-fold in the presence of rifampin. When delavirdine (400 mg three times a day for 30 days) was given with rifabutin (300 mg once daily on days 16 thru 30) in seven HIV-positive subjects, mean delavirdine Cmax, AUC and Cmin decreased by about 75%, 84% and 95%, respectively, and oral clearance increased by approximately 5-fold. Likewise, population pharmacokinetic data from efficacy studies showed that delavirdine Cmin was reduced by approximately 90% in patients (n=8) treated with various dosages of phenytoin, phenobarbital, and/or carbamazepine who were given delavirdine 300 to 400 mg three times a day.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, concomitant use of delavirdine with potent CYP450 3A4 inducers should generally be avoided.

References
  • Tran JQ, Gerber JG, Kerr BM "Delavirdine: clinical pharmacokinetics and drug interactions." Clin Pharmacokinet 40 (2001): 207-26
  • "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
  • Borin MT, Chambers JH, Carel BJ, Gagnon S, Freimuth WW "Pharmacokinetic study of the interaction between rifampin and delavirdine mesylate." Clin Pharmacol Ther 61 (1997): 544-53
  • "Product Information. Rescriptor (delavirdine)." Pharmacia and Upjohn, Kalamazoo, MI.
  • 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
  • Borin MT, Chambers JH, Carel BJ, Freimuth WW, Aksentijevich S, Piergies AA "Pharmacokinetic study of the interaction between rifabutin and delavirdine mesylate in HIV-1 infected patients." Antiviral Res 35 (1997): 53-63
Delavirdine

Generic Name: delavirdine

Brand name: Rescriptor

Synonyms: n.a.

Tegretol

Generic Name: carbamazepine

Brand name: Carbatrol, Epitol, Equetro, Tegretol, Tegretol XR, Tegretol, Tegretol XR

Synonyms: n.a.

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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