Kaletra Oral Solution and Rifadin

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.

Ask your doctor before using rifAMPin together with ritonavir. This combination can decrease the blood levels ritonavir. Talk with your doctor before using these medications together. You may need a dose adjustment or special tests to safely take 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.

GENERALLY AVOID: Coadministration with rifampin may decrease the plasma concentrations of ritonavir. The mechanism is rifampin induction of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of ritonavir. In seven study subjects, rifampin (300 or 600 mg daily for 10 days) decreased the mean steady-state peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of ritonavir (500 mg every 12 hours) by 25% and 35%, respectively, compared to data from nine control subjects. The clinical significance of this interaction is unknown but may be minor. In a small pilot study, protease inhibitor-naive, advanced HIV-infected patients received antituberculosis therapy with isoniazid, pyrazinamide, and rifampin (600 mg/day) for 2 months before starting concomitant antiretroviral treatment with ritonavir (600 mg twice a day) and two nucleoside reverse transcriptase inhibitors (NRTIs). The patients tolerated and responded well to both therapy during follow-up of up to 40 weeks, and drug levels were generally within normal limits relative to historical data and deemed therapeutically adequate. No additive hepatotoxic effects were apparent, with only mild elevations in serum transaminase levels reported (less than a 3-fold increase of normal values).

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, ritonavir labeling recommends that alternative antimycobacterial agents such as rifabutin be considered in HIV patients treated with ritonavir. However, some experts, as well as CDC guidelines, suggest that usual antituberculous dosages of rifampin may be used with ritonavir 400 to 600 mg twice daily in combination with one or more NRTIs. Rifampin should not be used with low-dose ritonavir (i.e. 100 mg twice daily given as a pharmacokinetic booster of other protease inhibitors), since low-dose ritonavir does not prevent rifampin-induced decreases in the concentrations of lopinavir and presumably other protease inhibitors. In general, treatment of tuberculosis (TB) in the context of antiretroviral therapy is complex and requires an individualized approach. Experts in the treatment of HIV-related TB should be consulted, and TB and HIV care providers should work in close coordination throughout treatment.

Kaletra Oral Solution

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: Kaletra

What is Kaletra Oral Solution?

Rifadin

Generic Name: rifampin

Brand name: Rifadin, Rifadin IV, Rimactane

Synonyms: n.a.

What is Rifadin?