Darunavir / ritonavir

Oxcarbazepine

Dose adjustment and closer monitoring may be required.

No pharmaceutical opinion available for this interaction.

Mechanism

Oxcarbazepine can induce the metabolism (CYP 3A4) and decrease the plasma concentration of Darunavir / ritonavir.

Darunavir / ritonavir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

Monitor for signs and symptoms of therapeutic failure.

Dosage adjustment may be required.

See comments.

Alternative solution(s)

Oxcarbazepine

Pharmacodynamic effects

Recommendations

Choose an alternative if possible.

Alternative solution(s)

As clinically indicated : brivaracetam, gabapentin, lacosamide, lamotrigine, levetiracetam, pregabalin, rufinamide, topiramate, vigabatrin, zonisamide.

Monitor

Tests

Darunavir plasma level

CD4+

Viral load HIV

Pharmacokinetic parameters

Comment

Ref #3570: TDM data were evaluated 11 HIV-positive patients treated concomitantly with carbamazepine or oxcarbazepine and antiretrovirals for at least 3 months. All the TDM evaluations for carbamazepine and oxcarbazepine were within therapeutic ranges. TDM results of darunavir measured in these patients were comparable to those in the control group.

Reference
  • 122
    Ritonavir (Norvir), Corporation AbbVie, Quebec, Canada, 5 juillet 2021.
  • 3141
    Oxcarbazepine (Trileptal), Novartis, Québec, Canada, 18 mars 2015.
  • 3570
    Cattaneo D, Baldelli S, Cozzi V, Fusi M, Atzori C, et al. Drug-Drug Interactions Between Antiretrovirals and Carbamazepine/Oxcarbazepine: A Real-Life Investigation. Ther Drug Monit. 2020 Apr; 42(2): 330-334.