Common drug-drug interactions with ART  Class of drug Concomitant medication PIs Anticoagulant: warfarin Anticonvulsants: carbamazepine, phenobarbital, phenytoin Antifungals: ketoconazole, itraconazole, voriconazole Calcium channel blockers: diltiazem, nifedipine, verapamil, amlodipine, nicardipine, isradipine, felodipine, bepridil
HMG-CoA reductase inhibitors (statins): lovastatin, simvastatin, atorvastatin Immunosuppressive drugs: cyclosporine, tacrolimus, sirolimus Opioids: methadone PD[E.
, clinidipine, clevidipine, diltazem, fendilinem,
Norvir should not be taken with the following medicines: astemizole, terfenadine, amiodarone, bepridil
, encainide, flecainide, propafenone, quinidine, dihydroergotamine, ergotamine, ergonovine, methylergonovine, clorazepate, diazepam, estazolam, flurazepam, triazolam or oral (taken by mouth) midazolam, clozapine, pimozide, pethidine, piroxicam, propoxyphene, cisapride rifabutin, voriconazole, simvastatin, lovastatin, alfuzosin, fusidic acid, sildenafil used to treat a lung disease called pulmonary arterial hypertension, and products containing St John's wort (Hypericum perforatum).
Effects of two Ca-entry blockers bepridil
and nitredipine on isolated vessels.
tetralols (such as bepridil
, which is no longer sold in the US).
On January 31 the FDA announced that the Sustiva (efavirenz) package insert had been changed "to include drug-drug interaction information regarding coadministration of efavirenz with rifampin, diltiazem, itraconazole, voriconazole, atorvastatin, pravastatin, simvastatin, pimozide and bepridil
The following drugs should not be combined with ritonavir: bepridil
(Vascor), amiodarone (Cordarone), flecainide (Tambocor), propafenone (Rythmol), quinidine (Quinidex), simvastatin (Zocor), lovastatin (Mevacor), cisapride (Propulsid), clozapine (Clozaril), midazolam (Versed), triazolam (Halcion), dihydroergotamine (DHE 45) and ergotamine (Cafergot).
All but 2 of these 13 criteria (use of bepridil
or phenylbutazone as first-line therapy) reference drug-drug interactions, and all can produce severe consequences.
Atripla should not be taken with bepridil
, cisapride, midazolam, pimozide, triazolam, or ergot derivatives due to a contraindication with efavirenz.
The concomitant use of strong CYP3A4 inhibitors or anti-arrhythmic drugs (including, but not limited to amiodarone, disopyramide, procainamide, quinidine, and sotalol) and other drugs that may prolong QT interval (including, but not limited to chloroquine, halofantrine, clarithromycin, haloperidol, methadone, moxifloxacin, bepridil
, and pimozide) should be avoided.
Constantin M, Bromont C, Fickat R, Massingham R (1990) Studies on the activity of Bepridil
as a scavenger of free radicals.
Amprenavir should not be given concurrently with bepridil
(Vascor), cisapride (Propulsid), dihydroergotamine (DHE 45), ergotamine (Ergostat), midazolam (Versed), triazolam (Halcion), rifampin (Rifadin, Rimactane) and the lipid-lowering agents simvastatin (Zocor) and lovastatin (Mevacor).