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.