https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=10005

Rilpivirine

Cimetidine

Spacing between medications is necessary when taken orally.

No pharmaceutical opinion available for this interaction.

Mechanism

Cimetidine by increasing gastric pH may decrease the solubility, absorption, and plasma concentration of Rilpivirine.

Rilpivirine

Pharmacodynamic effects

Possible decrease of clinical efficacy and risk of possible development of resistance to antiretroviral class.

Recommendations

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.

Alternative solution(s)

–

Cimetidine

Pharmacodynamic effects

–

Recommendations

Choose an alternative if it is considered necessary.

Alternative solution(s)

–

Monitor

–

Tests

Plasma level of rilpivirine

CD4+

Viral load HIV

Pharmacokinetic parameters

–

Comment

See famotidine and 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.

Comment
Reference
  • 2598
    Rilpivirine (Edurant), Janssen, Ontario, Canada, 20 janvier 2023.
  • 3441
    Dolutegravir/Rilpivirine (Juluca), ViiV Soins de santé ULC, Quebec, Canada, 5 juillet 2023.
  • 2587
    Emtricitabine/Rilpivirine/Ténofovir DF (Complera), Gilead, Ontario, Canada, 17 octobre 2019.
  • 3460
    Rilpivirine/Emtricitabine/Tenofovir alafenamide (Odefsey), Gilead Sciences, Ontario, Canada, 13 novembre 2019.
  • 2604
    Van Heeswijk RP, Hoetelmans RM, Kestens D, et al. The pharmacokinetic (PK) interaction between famotidine and TMC278, a next generation non-nucleoside reverse transcriptase inhibitor (NNRTI), in HIV-negative volunteers. 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention, July 22-25 2007, Sydney, Australia, abstract TUPDB01.
  • 2599
    Ford N, Lee J, Andrieux-Meyer I and Calmy A. Safety, efficacy, and pharmacokinetics of rilpivirine : systematic review with emphasis on resource-limited setting. HIV/AIDS – Reseach and Paliative Care 2011; 3: 34-55.