Antifungals
To date, very few studies have been performed to evaluate potential interactions between LAI ART and antifungal medications. Among antifungals, azoles are both substrates and potent inhibitors of the CYP3A4 system and are therefore prone to drug interactions. In particular, given that both rilpivirine and fluconazole have potential to prolong QT interval, caution and monitoring is recommended with this combination. One study which used a supratherapeutic dose of 400 mg/day of rilpivirine with ketoconazole reported a ~50% increase in rilpivirine AUC concentrations when the two agents were co-administered .While no dose adjustments arerecommended, monitoring of breakthrough fungal infections may be warranted when rilpivirine is coadministered with azoles, including fluconazole. Due to the potent induction properties of griseofulvin and its potential to reduce therapeutic effect of cabotegravir and/or rilpivirine co-administration is contraindicated, although no clinical data exists. No interactions are expected for amphotericin or flucytosine as those compounds do not undergo significant hepatic metabolism.