https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=15488
https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=15488
No pharmaceutical opinion available for this interaction.
Rifampicin can induce the metabolism (CYP 3A4) and decrease the plasma concentration of Atazanavir / cobicistat.
Possible decrease of clinical efficacy.
Risk of a possible development of resistance to antiretroviral class.
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In patients without resistance to integrase inhibitors, dolutegravir 50 mg BID or raltegravir 800 mg BID : see dolutegravir + rifampicin or raltegravir + rifampicin.
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Contraindicated. Use alternative.
Rifabutin with protease inhibitor boosted with ritonavir preferably (see rifabutin with PIs) or choose an antibiotic that does not interact with PIs.
Hepatotoxicity: elevation of hepatic transaminases by 3 to 5 fold, fatigue, unusual weakness, nausea, vomiting, anorexia, abdominal pains, pale stools, dark urine, jaundice.
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Co-administration of rifampicin 600 mg QD with protease inhibitors such as lopinavir/ritonavir, darunavir/ritonavir, atazanavir/ritonavir and atazanavir alone causes a decrease in AUC and Cmin of approximately 75% to 80%.
Ref #3116 : To increase the chance of achieving therapeutic serum levels and reduce the development of resistance and treatment failures some experts, as well as the CDC, recommend a 150mg QD dose. See rifabutin + PIs.