https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=10004
https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=10004
No pharmaceutical opinion available for this interaction.
Famotidine by increasing gastric pH may decrease the solubility, absorption, and plasma concentration of Rilpivirine.
Possible decrease of clinical efficacy and risk of possible development of resistance to antiretroviral class.
Should be administered at least 4 hours before or at least 12 hours after the H2 blocker.
Monitor for clinical efficacy.
See comments for further details.
Cabenuva : No anticipated interaction so no adjustments necessary.
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Choose an alternative if it is considered necessary.
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Plasma level of rilpivirine
CD4+
Viral load HIV
| Reference number |
|---|
| # patients |
| HIV |
| Dose |
| Frequency |
| AUC |
| Cmax |
| 2604 | 2604 | 2604 |
|---|---|---|
| 24 | 23 | 24 |
| - | - | - |
| 40 mg* | 40 mg** | 40 mg*** |
| x1 | x1 | x1 |
| 2604 | 2604 | 2604 |
|---|---|---|
| 23 | 24 | 24 |
| - | - | - |
| 150 mg | 150 mg | 150 mg |
| x1 | x1 | x1 |
| - 9% | - 76% | + 13% |
| - 1% | - 85% | + 21% |
Ref #2604:
* 12 hours before Rilpivirine,
** 2 hours before Rilpivirine,
*** 4 hours after Rilpivirine.
The combination of Rilpivirine and H2-receptor antagonists should be used with caution as coadministration may cause significant decreases in rilpivirine plasma concentrations. H2-receptor antagonists should be administered 12 hours before or 4 hours after rilpivirine.
Note, the recommended anti-H2 dosage frequency is QD:
Take rilpivirine 12 hours after the H2 antagonist.
Eg: Rilpivirine (with food) at 9 am and the H2 antagonist at 9 pm.
If it is necessary to take the dosage BID:
Take the first dosage of the H2 antagonist 3 hours after the rilpivirine intake, and the second dosage of the H2 antagonist 12 hours before the next dosage of rilpivine.
Eg: Rilpivirine (with food) at 9 am and the H2 antagonist at 1 pm and 9 pm.