DRUG INTERACTION: Lamotrigine + Antiretrovirals

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

Efavirenz

Ritonavir

Zidovudine

Lopinavir

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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.

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

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Dr. Harvinder Singh, M.D. (Admin)

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DRUG INTERACTION: Lamotrigine + Antiretrovirals

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

Efavirenz

Ritonavir

Zidovudine

Lopinavir

Time's up

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:

Please do post your questions or comments below.

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:

Please do post your questions or comments below.

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