Darunavir / cobicistat

Nitrazepam

Evaluate risk/benefit ratio.

No pharmaceutical opinion available for this interaction.

Mechanism

Darunavir / cobicistat can inhibit the metabolism (CYP 3A4) and increase the plasma concentration of Nitrazepam.

Darunavir / cobicistat

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Nitrazepam

Pharmacodynamic effects

Increased risk of CNS toxicity.

Risk of prolonged sedation and respiratory depression.

Recommendations

Use with caution the lowest effective dose and adjust according to clinical response and tolerance.

Monitor closely for adverse effects.

Or choose an alternative.

In patients already being treated with this combination and tolerating it, if deemed appropriate, keep actual treatment and exercise close monitoring of adverse effects.

Alternative solution(s)

Lorazepam (Ativan), temazepam (Restoril), oxazepam (Serax)

Monitor

Benzodiazepine toxicity: drowsiness, dizziness, ataxia, problem of coordination, confusion, decrease of reflexes, excessive sedation, respiratory depression and coma.

Tests

Pharmacokinetic parameters

Comment

Reference
  • 3303
    Nitrazepam (Mogadon), AA Pharma, Ontario, Canada, 28 nov. 2013.