Annex 2Drug Interactions

Publication Details

The drug interactions included in this table were selected on the basis of their potential clinical significance and are not inclusive of all potential drug interactions.

Drug interactions involving oral azole antifungal drugs.

Table

Drug interactions involving oral azole antifungal drugs.

Drug interactions involving oral griseofulvin.

Table

Drug interactions involving oral griseofulvin.

Drug interactions involving oral antiviral drugs.

Table

Drug interactions involving oral antiviral drugs.

Drug interactions involving ivermectin.

Table

Drug interactions involving ivermectin.

Publication Details

Copyright

Copyright © World Health Organization 2014.

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Publisher

World Health Organization, Geneva

NLM Citation

Guidelines on the Treatment of Skin and Oral HIV-Associated Conditions in Children and Adults. Geneva: World Health Organization; 2014. Annex 2, Drug Interactions.

Drug interactions involving oral azole antifungal drugs

EFFECT		AZOLE(S) INVOLVED
DECREASED PLASMA CONCENTRATION OF AZOLE
Decreased absorption of azole
	Antacids, H2 receptor antagonists, sucralfate, omeprazole, didanosine (oral)	Itraconazole
Increased metabolism of azole
	Isoniazid, phenytoin, carbamazepine, phenobarbital, nevirapine, efavirenz	Itraconazole
	Rifampin	Itraconazole, fluconazole
INCREASED PLASMA CONCENTRATION OF COADMINISTERED DRUG
	Cyclosporine, phenytoin, sulfonylureas, warfarin, triazolam, alprazolam, midazolam, protease inhibitors	Itraconazole, fluconazole
	Tacrolimus, nortriptyline, rifabutin, zidovudine, stavudine	Fluconazole
	Loratadine, felodipine, nifedipine, lovastatin, digoxin	Itraconazole

: Modified from Hoesley C, Dismukes WE. Overview of oral azole drugs as systemic antifungal therapy. Semin Resp Crit Care Med. 1997;18:301–9, quoted in: Dismukes WE. Introduction to antifungal drugs. Clin Infect Dis. 2000;30:653–7. [PubMed: 10770726].

Drug interactions involving oral griseofulvin

EFFECT
DECREASED PLASMA CONCENTRATION OF CO-ADMINISTERED DRUG
	Oral contraceptives (e.g. ethinyl estradiol/norethindrone)

: The combination of alcohol and griseofulvin may cause flushing and a fast heart rate. Use alcohol cautiously during treatment with griseofulvin.

Drug interactions involving oral antiviral drugs

EFFECT		ANTIVIRAL INVOLVED
INCREASED PLASMA CONCENTRATIONS OF CO-ADMINISTERED DRUG
	Tenofovir	Acyclovir, valaciclovir, famciclovir^a

a: There is increased concentration of both drugs and both are nephrotoxic; renal function needs to monitored when co-administered. For ART drug interactions refer to WHO’s ART guidelines (WHO, 2013).

Drug interactions involving ivermectin^a

DECREASED PLASMA CONCENTRATION OF IVERMECTIN
	Nevirapine, efavirenz, rifapentine
DECREASED PLASMA CONCENTRATION OF IVERMECTIN
	Sirolimus
INCREASED PLASMA CONCENTRATION OF COADMINISTERED DRUG
	Tacrolimus, warfarin, sirolimus

a: These are some of the reported interactions, may not need dose modifications.