DRUG INTERACTION: Lamotrigine + Antiretrovirals

Dr. Harvinder Singh August 19, 2018

Q: Which of the following antiretroviral is NOT likely to decrease lamotrigine plasma concentrations?

 

BEFORE SCROLLING DOWN ==>

SUBMIT YOUR ANSWERS FIRST 🙂

.

.

.

.

 

 

REDUCED LAMOTRIGINE LEVELS

  • Atazanavir/Ritonavir: may decrease lamotrigine plasma concentrations due to UGT1A4 induction.

  • Efavirenz: induces UGT1A4 and therefore could potentially decrease lamotrigine exposure. 

  • Ritonavir: induces oxidation by CYP2C9 and glucuronidation and as a result is expected to decrease the plasma concentrations of lamotrigine. 

  • Lopinavir: Lamotrigine exposure markedly decreased (~50%) when coadministered with lopinavir, probably by induction of glucuronidation.

  • Saquinavir/Ritonavir: could potentially decrease lamotrigine exposure possibly due to induction of glucuronidation. 

 

INCREASED LAMOTRIGINE LEVELS

  • Saquinavir: ?? according to maudsley prescribing guidelines, but accoridng to epocrates: no drug interaction; and according to online hiv-drug interactions: potential risk of reduction in lamotrigine.

 

NO INTERACTIONS WITH LAMOTRIGINE

  • Abacavir

  • Didanosine (ddI)

  • Lamivudine (3TC)

  • Nevirapine

  • Stavudine (d4T)

  • Zidovudine (AZT/ZDV)

 

 

Source:
    1. Current Psychiatry. 2018 May;17(5):35-36,41-44,46.

 

  1. Psychosomatics. 2010 Nov-Dec;51(6):480-8. 
  2. AIDS Rev. 2012 Apr-Jun;14(2):101-11.
  3. Maudsley prescribing guidelines.
  4. hiv-druginteractions online calculator.

Please do post your questions or comments below. 

Dr. Harvinder Singh, M.D. (Admin)

Enroll in our online course to have access to all important clinically relevant psychiatry topics in one place.

Click Here to Enroll in Course

Share
Categories: Psycho-Pharmacology
Tagged: ,

Related Articles

Report

Harassment or bullying behavior
Contains mature or sensitive content
Contains misleading or false information
Contains abusive or derogatory content
Contains spam, fake content or potential malware

Block Member?

Please confirm you want to block this member.

You will no longer be able to:

  • See blocked member's posts
  • Mention this member in posts
  • Invite this member to groups
  • Message this member
  • Add this member as a connection

Please note: This action will also remove this member from your connections and send a report to the site admin. Please allow a few minutes for this process to complete.

Report

You have already reported this