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Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents

Drug Interactions

Interactions between Protease Inhibitors

(Last updated:3/27/2012; last reviewed:2/12/2013)

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*Nelfinavir (NFV) and indinavir (IDV) are not included in this table. Please refer to NFV and IDV Food and Drug Administration package inserts for information regarding NFV and IDV drug interactions.

Table 16a. Interactions Among Protease Inhibitors*
Drug Affected ATV FPV  LPV/r  RTV  SQV  TPV 
 DRV Dose: ATV 300 mg once daily + DRV 600 mg BID + RTV 100 mg BID  No data  Should not be co-administered because doses are not established Dose: (DRV 600 mg + RTV 100 mg) BID or (DRV 800 mg + RTV 100 mg) once daily  Should not be co-administered because doses are not established  No data
 FPV  Dose: Insufficient data Should not be co-administered because doses are not established  Dose: (FPV 1400 mg + RTV 100 mg or 200 mg) once daily; or (FPV 700 mg + RTV 100 mg) BID  Dose: Insufficient data Should not be co-administered because doses are not established
 LPV/r  Dose: ATV 300 mg once daily + LPV/r 400/100 mg BID  Should not be co-administered because doses are not established    LPV is coformulated with RTV as Kaletra.  Dose: SQV 1000 mg BID + LPV/r 400/100 mg BID  Should not be co-administered because doses are not established
 RTV  Dose: (ATV 300 mg + RTV 100 mg) once daily  Dose: (FPV 1400 mg + RTV [100 mg or 200 mg]) once daily;
or
(FPV 700 mg + RTV 100 mg) BID
 LPV is coformulated with RTV and marketed as Kaletra.  •  Dose: (SQV 1000 mg + RTV 100 mg) BID  Dose: (TPV 500 mg + RTV 200 mg) BID
 SQV  Dose: Insufficient data  Dose: Insufficient data  Dose: SQV 1000 mg BID + LPV/r 400/100 mg BID  Dose: (SQV 1000 mg + RTV 100 mg) BID   •  Should not be co-administered because doses are not established

Key to Abbreviations: ATV = atazanavir, BID = twice daily, DRV = darunavir, FDA = Food and Drug Administration, FPV = fosamprenavir, IDV = indinavir, LPV/r = lopinavir/ritonavir, NFV = nelfinavir, PI = protease inhibitor, RTV = ritonavir, SQV = saquinavir, TPV = tipranavir