TUONG TAC CUA CAC THUOC ARV

  





































































































Thuoc khang retrovirus
Cac thuoc tuong tac
Co che/Tac dung
Khuyen nghi

LPV/r
Clarithromycin
uc che  chuyen hoa -  nong do clarithromycin tang
Chi dieu chinh lieu clarithromycin khi co suy than.

EFV, NVP
Clarithromycin
Kich thich chuyen hoa -  giam nong do clarithromycin
Hieu qua dieu tri va du phong MAC co the bi giam, can theo doi sat.

EFV
Rifabutin
Kich thich chuyen hoa, giam dang ke nong do rifabutin/ Muc efavirenz co the giam
Tang lieu rifabutin len 450-600 mg hang ngay hoac 600 mg hai lan trong 1 tuan.

Khong can thiet thay doi lieu efavirenz.

ddI
Gancyclovir
Muc ddI tang gan 100%
Theo doi tac dung phu lien quan den ddI

LPV/r
 Ketoconazole
uc che  chuyen hoa, nong do ketoconazole tang
Su dung than trong voi lieu ketoconazole > 200 mg/ngay

ddI
Khang sinh quinolone
Su ion duong hoa lam giam dang ke nong do cac thuoc quinolone
Su dung cac thuoc co dien tich duong it nhat 2 gio sau khi uong quinolone.   

DLV
Rifabutin
Kich thich chuyen hoa, giam dang ke nong do delavirdine
Tranh su dung dong thoi hai loai thuoc nay

RTV, LPV/r, SQV/r, IDV, NFV, APV
Rifabutin
uc che chuyen hoa, tang dang ke nong do rifabutin/ Kich thich chuyen hoa, nong do saquinavir co the giam
Giam rifabutin xuong 150 mg cach ngay hoac 3 lan mot tuan.

Can nhac tang lieu indinavir len 1000mg 8 gio mot lan neu day la thuoc PI duy nhat; khong thay doi lieu cua cac thuoc PI khac

NVP, APV, DLV, IDV, LPV/r, NFV, SQV
Rifamycin
Kich thich chuyen hoa, giam dang ke nong do NVP, cac thuoc uc che protease hoac nong do delavirdine
Tranh su dung dong thoi cac thuoc nay

EFV, RTV, SQV/r, NVP
Rifamycin
Kich thich chuyen hoa, giam muc cac thuoc uc che protease hoac nevirapine
Co the dung ket hop.

Can nhac tang lieu efavirenz len 800mg/ngay khi su dung voi rifamycin.

d4T, NVP, EFV, RTV, SQV, NFV, LPV
Methadone
Giam nong do methadone
Chu y hoi chung cai nghien; co the phai tang lieu methadone

IDV, ATV
Cac thuoc tranh thai Norethindrone, Ethinyl estradiol
Tang nong do cac thuoc tranh thai
Khong can dieu chinh lieu cac thuoc tranh thai

NVP, RTV, NFV, APV, LPV
Ethyl estradiol
Giam dang ke nong do Ethyl estradiol
Su dung bien phap tranh thai thay the hoac ho tro.

ddI
TDF
Nong do ddI tang
Giam lieu ddI xuong 250mg moi ngay

IDV, SQV va mot so thuoc ARV khac
Carbamazepine Phenobarbitol, Phenytoin
Giam nong do IDV,  SQV va mot so thuoc ARV khac
Than trong khi dung dong thoi, xem xet dung thuoc ARV thay the; theo doi tac dung cua cac thuoc chong co giat.