Darunavir / ritonavir

Lamotrigine

Dosage adjustment may be necessary.

No pharmaceutical opinion available for this interaction.

Mechanism

Darunavir / ritonavir can induce the metabolism (UGT 1A4) and decrease the concentration of Lamotrigine.

Darunavir / ritonavir

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Lamotrigine

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

An increase in dosage may be necessary.

Monitor for signs and symptoms of therapeutic failure.

Alternative solution(s)

Monitor

Tests

Lamotrigine

Pharmacokinetic parameters

Comment

Pharmacokinetic studies showed that the addition of a protease inhibitor (PI) combination containing ritonavir decreases lamotrigine plasma concentrations of about 32 to 55%. A lamotrigine dose of 200 mg BID with PI produces a concentration similar to lamotrigine 100 mg BID used alone.

See atazanavir/ritonavir + lamotrigine and lopinavir/ritonavir + lamotrigine.

Reference
  • 122
    Ritonavir (Norvir), Corporation AbbVie, Quebec, Canada, 25 septembre 2018.
  • 2111
    Van der Lee MJ, Dawood L, ter Hofstede H, et al. Lopinavir/ritonavir reduces lamotrigine plasma concentrations in healthy subjects. Clin Pharmacol Ther 2006; 80:159-168.
  • 2221
    Burger D, Huisman A, Van Ewijk N, Neisingh H, Van Uden P, Rongen G, Koopmans P, Bertz R. The Effect of Atazanavir and Atazanavir/Ritonavir on UDP-Glucuronosyltransferase Using Lamotrigine as a Phenotypic Probe. Clin Pharmacol Ther. 2008.