How do antimalarials and protease inhibitors (PIs) interact?

Updated: Jan 15, 2019
  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michelle R Salvaggio, MD, FACP  more...
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Answer

Answer

Coadministration of artemether/lumefantrine with DRV/r or LPV/r decreases AUC of artemether and dihydroartemisinin and increases lumefantrine AUC; clinical significance is unknown; if used, monitor closely for antimalarial efficacy and lumefantrine toxicity.

Coadministration of atovaquone/proguanil with ATV/r or LPV/r decreases AUC of both atovaquone and proguanil; consider alternative drug for malaria prophylaxis, if possible.

Coadministration of mefloquine with RTV 200 mg BID reduces RTV AUC by 31% and Cmin by 43%; use with caution; effect on exposure of RTV-boosted PIs is unknown.


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