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Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis

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Table 2b. Recommendations for coadministering antiretroviral drugs with rifampin in children – 2013

Antiretroviral drug regimen choices*

Recommended change in dose of antiretroviral drug

Recommended change in dose of rifampin


   “Super-boosted” lopinavir / ritonavir
   + 2 NRTIs

Pediatric weight-adjusted dosing for lopinavir/ritonavir* (Kaletra™)  PLUS added ritonavir to reach mg to mg parity of lopinavir and ritonavir doses

No change



(standard pediatric weight-adjusted dosing*)

No change

Alternative for children <3 years


   Efavirenz + 2 NRTIs



(standard pediatric weight-adjusted dosing*)


No change


Efavirenz AUC ↓ by 20-30% on average, though effect is highly variable.

Alternative for children age >3 years.

Careful monitoring of virologic response; therapeutic drug monitoring of efavirenz levels if available


* For pediatric dosing see: Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. August 11, 2011; pp 1-268. Available at The U.S. Government's Official Web PortalDepartment of Health and Human Services
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