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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

Comments

   “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

Preferred.

Zidovudine/lamivudine/abacavir

None
(standard pediatric weight-adjusted dosing*)

No change

Alternative for children <3 years

 

   Efavirenz + 2 NRTIs

 

 

None
(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 http://aidsinfo.nih.gov/ContentFiles/PediatricGuidelines.pdf.

 

 
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