Interaction matrix

Each coloured cell is an interaction in the engine's table, taken from SmPC §4.3 or §4.5 of the named UK product and checked against its text. A blank cell means “not in this table”, not “no interaction” — always check the Liverpool HIV interaction checker.

C — contraindicatedA — avoid / not recommended D — dose or timing adjustmentM — monitor

	Bictegravir	Dolutegravir	Raltegravir	Cabotegravir	Doravirine	Rilpivirine	Efavirenz	Darunavir	Atazanavir	Ritonavir	Cobicistat	Tenofovir alafenamide	Tenofovir disoproxil
Rifampicin	C	D	D	C	C	C	M	C	C			A
Rifabutin	A			A	D	D				D		A
Carbamazepine	A	D		C	C	C					C	A
Oxcarbazepine	A	A		C	C	C
Phenytoin / fosphenytoin	A	A		C	C	C					C	A
Phenobarbital / primidone	A	A		C	C	C					C
St John's wort	C	A			C	C	C	C	C			A
Proton pump inhibitor (e.g. omeprazole)						C			A
H2-receptor antagonist (e.g. famotidine)						D			D
Antacids / polyvalent cations (Al, Mg, Ca, Fe, Zn)	D	D	A	D		D
Simvastatin or lovastatin										C	C
Atorvastatin or rosuvastatin										D	D
Amiodarone										C	A
Fampridine (Fampyra)		C
Rivaroxaban / apixaban / dabigatran										A	A
Ticagrelor or clopidogrel										A	C
Metformin	M	D
Dexamethasone (systemic, more than one dose)						C
Fluticasone / budesonide (inhaled or nasal)										A	A
Salmeterol										A	A
Hormonal contraception (oral, implant, patch)							A			D	M
Methadone							D			M
Midazolam (oral) or triazolam							C			C	C
Quetiapine										C	C
Pimozide or lurasidone							C			C	C
Sildenafil for pulmonary arterial hypertension										C	C
Colchicine										D	D
Ergot derivatives (ergotamine)							C			C	C
Sofosbuvir/velpatasvir (Epclusa)							A						M
Glecaprevir/pibrentasvir (Maviret)							A	A	C
Elbasvir/grazoprevir (Zepatier)							C	C	C		C
Ledipasvir/sofosbuvir (Harvoni)													M
Rifapentine	A			C	C	C		A				A
Clarithromycin	M					A	M		M
Itraconazole or posaconazole								D			D
Voriconazole							D	A			A
Artemether/lumefantrine (Riamet)							M	M
Atovaquone/proguanil (Malarone)							A
Tacrolimus or ciclosporin							D	D
Dronedarone or ranolazine										C	C
Ivabradine								C			C
Digoxin								M
Lomitapide										C	C
Domperidone								C			C
Naloxegol								C			C
Alfuzosin									C	C	C
Sildenafil/tadalafil/vardenafil for erectile dysfunction								D
Avanafil										C	C
Lamotrigine									D	M
SSRIs or trazodone								D
Fentanyl or oxycodone								M
Corticosteroid injections (e.g. triamcinolone, methylprednisolone)								A
Bosentan					D

Details

Co-medication	Antiretroviral	Severity	Effect and management	Source
Alfuzosin	Ritonavir	contraindicated	Ritonavir raises alfuzosin (hypotension).	Norvir §4.3
Alfuzosin	Cobicistat	contraindicated	Cobicistat raises alfuzosin.	Rezolsta §4.3
Alfuzosin	Atazanavir	contraindicated	Atazanavir raises alfuzosin.	Atazanavir 300 mg (generic) §4.3
Amiodarone	Ritonavir	contraindicated	Ritonavir raises amiodarone (arrhythmia risk).	Norvir §4.3
Amiodarone	Cobicistat	avoid	Cobicistat raises amiodarone.	Rezolsta §4.5
Antacids / polyvalent cations (Al, Mg, Ca, Fe, Zn)	Raltegravir	avoid	Aluminium/magnesium antacids chelate raltegravir.	Isentress §4.5
Antacids / polyvalent cations (Al, Mg, Ca, Fe, Zn)	Bictegravir	adjust	Polyvalent cations chelate bictegravir.	Biktarvy §4.5
Antacids / polyvalent cations (Al, Mg, Ca, Fe, Zn)	Dolutegravir	adjust	Polyvalent cations chelate dolutegravir. Take dolutegravir 2 h before or 6 h after antacids/supplements (iron or calcium may be taken together with dolutegravir with food)	Tivicay §4.5
Antacids / polyvalent cations (Al, Mg, Ca, Fe, Zn)	Cabotegravir	adjust	Polyvalent-cation antacids lower oral cabotegravir. Oral cabotegravir 2 h before or 4 h after antacids Applies to oral dosing only.	Vocabria tablets §4.5
Antacids / polyvalent cations (Al, Mg, Ca, Fe, Zn)	Rilpivirine	adjust	Antacids lower oral rilpivirine absorption. Antacids ≥2 h before or ≥4 h after rilpivirine Applies to oral dosing only.	Edurant §4.5
SSRIs or trazodone	Darunavir	adjust	Boosted darunavir alters SSRI and trazodone exposure. Titrate the antidepressant to clinical response; monitor	Prezista 800 mg §4.5
Artemether/lumefantrine (Riamet)	Darunavir	monitor	Boosted darunavir raises lumefantrine — use with caution.	Prezista 800 mg §4.5
Artemether/lumefantrine (Riamet)	Efavirenz	monitor	Efavirenz lowers artemether and lumefantrine — risk of malaria treatment failure.	Efavirenz 600 mg (generic) §4.5
Atorvastatin or rosuvastatin	Cobicistat	adjust	Boosted darunavir raises atorvastatin/rosuvastatin. Start atorvastatin at 10 mg and titrate; use the lowest effective rosuvastatin dose	Rezolsta §4.5
Atorvastatin or rosuvastatin	Ritonavir	adjust	Boosted darunavir raises atorvastatin/rosuvastatin. Start atorvastatin at 10 mg and titrate; use the lowest effective rosuvastatin dose	Prezista 800 mg §4.5
Atovaquone/proguanil (Malarone)	Efavirenz	avoid	Efavirenz lowers atovaquone and proguanil.	Efavirenz 600 mg (generic) §4.5
Avanafil	Ritonavir	contraindicated	Ritonavir raises avanafil.	Norvir §4.3
Avanafil	Cobicistat	contraindicated	Cobicistat raises avanafil.	Rezolsta §4.3
Bosentan	Doravirine	adjust	Bosentan (a moderate CYP3A inducer) lowers doravirine. If unavoidable, doravirine 100 mg twice daily (about 12 h apart)	Pifeltro §4.5
Carbamazepine	Rilpivirine	contraindicated	Carbamazepine markedly lowers rilpivirine.	Edurant §4.3
Carbamazepine	Doravirine	contraindicated	Carbamazepine markedly lowers doravirine.	Pifeltro §4.3
Carbamazepine	Cabotegravir	contraindicated	Carbamazepine markedly lowers cabotegravir.	Vocabria tablets §4.3
Carbamazepine	Cobicistat	contraindicated	Carbamazepine lowers cobicistat and the boosted PI.	Rezolsta §4.3
Carbamazepine	Bictegravir	avoid	Carbamazepine lowers bictegravir exposure.	Biktarvy §4.5
Carbamazepine	Tenofovir alafenamide	avoid	Carbamazepine lowers tenofovir alafenamide exposure.	Descovy §4.5
Carbamazepine	Dolutegravir	adjust	Carbamazepine lowers dolutegravir exposure. Dolutegravir 50 mg twice daily with carbamazepine (avoid with integrase resistance)	Tivicay §4.5
Clarithromycin	Rilpivirine	avoid	Clarithromycin raises rilpivirine (QT prolongation); use azithromycin where possible.	Edurant §4.5
Clarithromycin	Efavirenz	monitor	Efavirenz lowers clarithromycin; azithromycin may be considered.	Efavirenz 600 mg (generic) §4.5
Clarithromycin	Bictegravir	monitor	Clarithromycin may raise bictegravir — caution.	Biktarvy §4.5
Clarithromycin	Atazanavir	monitor	Atazanavir raises clarithromycin; no dose recommendation — caution.	Atazanavir 300 mg (generic) §4.5
Colchicine	Ritonavir	adjust	Ritonavir raises colchicine; contraindicated with renal or hepatic impairment. Reduce colchicine dose; do not combine if renal or hepatic impairment	Norvir §4.3
Colchicine	Cobicistat	adjust	Cobicistat raises colchicine; contraindicated with renal or hepatic impairment. Reduce colchicine dose; do not combine if renal or hepatic impairment	Rezolsta §4.3
Dexamethasone (systemic, more than one dose)	Rilpivirine	contraindicated	Systemic dexamethasone (more than a single dose) lowers rilpivirine.	Edurant §4.3
Digoxin	Darunavir	monitor	Boosted darunavir (P-gp inhibition) raises digoxin — start low and monitor levels.	Prezista 800 mg §4.5
Rivaroxaban / apixaban / dabigatran	Cobicistat	avoid	Cobicistat raises rivaroxaban/apixaban/dabigatran exposure (bleeding).	Rezolsta §4.5
Rivaroxaban / apixaban / dabigatran	Ritonavir	avoid	Ritonavir-boosted darunavir raises rivaroxaban/apixaban (bleeding).	Prezista 800 mg §4.5
Domperidone	Darunavir	contraindicated	Boosted darunavir raises domperidone (QT prolongation).	Prezista 800 mg §4.3
Domperidone	Cobicistat	contraindicated	Cobicistat raises domperidone.	Rezolsta §4.3
Dronedarone or ranolazine	Ritonavir	contraindicated	Ritonavir raises dronedarone/ranolazine (arrhythmia).	Norvir §4.3
Dronedarone or ranolazine	Cobicistat	contraindicated	Cobicistat raises dronedarone/ranolazine.	Rezolsta §4.3
Elbasvir/grazoprevir (Zepatier)	Darunavir	contraindicated	Boosted darunavir raises grazoprevir (ALT elevations).	Prezista 800 mg §4.3
Elbasvir/grazoprevir (Zepatier)	Cobicistat	contraindicated	Cobicistat-boosted darunavir raises grazoprevir.	Rezolsta §4.3
Elbasvir/grazoprevir (Zepatier)	Efavirenz	contraindicated	Efavirenz markedly lowers elbasvir and grazoprevir.	Efavirenz 600 mg (generic) §4.3
Elbasvir/grazoprevir (Zepatier)	Atazanavir	contraindicated	Atazanavir raises grazoprevir.	Atazanavir 300 mg (generic) §4.3
Ergot derivatives (ergotamine)	Ritonavir	contraindicated	Ritonavir raises ergot alkaloids (ergotism).	Norvir §4.3
Ergot derivatives (ergotamine)	Cobicistat	contraindicated	Cobicistat raises ergot alkaloids (ergotism).	Rezolsta §4.3
Ergot derivatives (ergotamine)	Efavirenz	contraindicated	Efavirenz with ergot derivatives — risk of serious reactions.	Efavirenz 600 mg (generic) §4.3
Fampridine (Fampyra)	Dolutegravir	contraindicated	Dolutegravir inhibits OCT2 and raises fampridine (seizure risk) — narrow-therapeutic-index OCT2 substrates are contraindicated.	Tivicay §4.3
Glecaprevir/pibrentasvir (Maviret)	Atazanavir	contraindicated	Atazanavir raises glecaprevir/pibrentasvir (ALT elevations).	Atazanavir 300 mg (generic) §4.3
Glecaprevir/pibrentasvir (Maviret)	Darunavir	avoid	Boosted darunavir raises glecaprevir/pibrentasvir.	Prezista 800 mg §4.5
Glecaprevir/pibrentasvir (Maviret)	Efavirenz	avoid	Efavirenz lowers glecaprevir/pibrentasvir.	Efavirenz 600 mg (generic) §4.5
H2-receptor antagonist (e.g. famotidine)	Rilpivirine	adjust	H2-receptor antagonists lower oral rilpivirine absorption. Give the H2-antagonist ≥12 h before or ≥4 h after rilpivirine Applies to oral dosing only.	Edurant §4.5
H2-receptor antagonist (e.g. famotidine)	Atazanavir	adjust	H2-receptor antagonists lower atazanavir absorption.	Atazanavir 300 mg (generic) §4.5
Hormonal contraception (oral, implant, patch)	Efavirenz	avoid	Efavirenz lowers etonogestrel and levonorgestrel — implant and progestogen-only methods may fail.	Efavirenz 600 mg (generic) §4.5
Hormonal contraception (oral, implant, patch)	Ritonavir	adjust	Ritonavir-boosted darunavir lowers ethinylestradiol. Use an additional or alternative (non-hormonal) contraceptive method	Prezista 800 mg §4.5
Hormonal contraception (oral, implant, patch)	Cobicistat	monitor	Cobicistat-boosted darunavir alters ethinylestradiol and drospirenone exposure.	Rezolsta §4.5
Fluticasone / budesonide (inhaled or nasal)	Ritonavir	avoid	Ritonavir raises fluticasone/budesonide — Cushing's syndrome and adrenal suppression reported.	Norvir §4.5
Fluticasone / budesonide (inhaled or nasal)	Cobicistat	avoid	Cobicistat raises fluticasone/budesonide (Cushing's syndrome).	Rezolsta §4.5
Itraconazole or posaconazole	Darunavir	adjust	Boosted darunavir and azoles raise each other's levels. Itraconazole no more than 200 mg/day with boosted darunavir; monitor	Prezista 800 mg §4.5
Itraconazole or posaconazole	Cobicistat	adjust	Cobicistat-boosted darunavir and azoles raise each other's levels. Itraconazole no more than 200 mg/day with darunavir/cobicistat; monitor	Rezolsta §4.5
Ivabradine	Cobicistat	contraindicated	Cobicistat raises ivabradine.	Rezolsta §4.3
Ivabradine	Darunavir	contraindicated	Boosted darunavir raises ivabradine.	Prezista 800 mg §4.3
Lamotrigine	Atazanavir	adjust	Atazanavir/ritonavir lowers lamotrigine. Monitor lamotrigine levels and adjust the dose	Atazanavir 300 mg (generic) §4.5
Lamotrigine	Ritonavir	monitor	Ritonavir induces glucuronidation and lowers lamotrigine.	Norvir §4.5
Ledipasvir/sofosbuvir (Harvoni)	Tenofovir disoproxil	monitor	Ledipasvir/sofosbuvir raises tenofovir — monitor renal function.	Viread §4.5
Lomitapide	Ritonavir	contraindicated	Ritonavir raises lomitapide (hepatotoxicity).	Norvir §4.3
Lomitapide	Cobicistat	contraindicated	Cobicistat raises lomitapide.	Rezolsta §4.3
Metformin	Dolutegravir	adjust	Dolutegravir raises metformin (OCT2/MATE1 inhibition). Consider a metformin dose adjustment when starting or stopping dolutegravir; monitor renal function	Tivicay §4.5
Metformin	Bictegravir	monitor	Bictegravir raises metformin exposure.	Biktarvy §4.5
Methadone	Efavirenz	adjust	Efavirenz lowers methadone — withdrawal symptoms. Monitor for opioid withdrawal; methadone dose often needs increasing	Efavirenz 600 mg (generic) §4.5
Methadone	Ritonavir	monitor	Ritonavir-boosted darunavir lowers methadone.	Prezista 800 mg §4.5
Midazolam (oral) or triazolam	Ritonavir	contraindicated	Ritonavir markedly raises oral midazolam/triazolam.	Norvir §4.3
Midazolam (oral) or triazolam	Cobicistat	contraindicated	Cobicistat markedly raises oral midazolam/triazolam.	Rezolsta §4.3
Midazolam (oral) or triazolam	Efavirenz	contraindicated	Efavirenz competes for CYP3A4 with midazolam/triazolam.	Efavirenz 600 mg (generic) §4.3
Naloxegol	Darunavir	contraindicated	Boosted darunavir raises naloxegol.	Prezista 800 mg §4.3
Naloxegol	Cobicistat	contraindicated	Cobicistat raises naloxegol.	Rezolsta §4.3
Fentanyl or oxycodone	Darunavir	monitor	Boosted darunavir raises fentanyl and oxycodone — risk of respiratory depression.	Prezista 800 mg §4.5
Oxcarbazepine	Rilpivirine	contraindicated	Oxcarbazepine lowers rilpivirine.	Edurant §4.3
Oxcarbazepine	Doravirine	contraindicated	Oxcarbazepine lowers doravirine.	Pifeltro §4.3
Oxcarbazepine	Cabotegravir	contraindicated	Oxcarbazepine lowers cabotegravir.	Vocabria tablets §4.3
Oxcarbazepine	Bictegravir	avoid	Oxcarbazepine lowers bictegravir exposure.	Biktarvy §4.5
Oxcarbazepine	Dolutegravir	avoid	Oxcarbazepine lowers dolutegravir exposure.	Tivicay §4.5
Sildenafil/tadalafil/vardenafil for erectile dysfunction	Darunavir	adjust	Boosted darunavir raises PDE-5 inhibitors. Use reduced PDE-5 inhibitor doses (e.g. sildenafil 25 mg in 48 h, tadalafil 10 mg in 72 h)	Prezista 800 mg §4.5
Phenobarbital / primidone	Rilpivirine	contraindicated	Phenobarbital lowers rilpivirine.	Edurant §4.3
Phenobarbital / primidone	Doravirine	contraindicated	Phenobarbital lowers doravirine.	Pifeltro §4.3
Phenobarbital / primidone	Cabotegravir	contraindicated	Phenobarbital lowers cabotegravir.	Vocabria tablets §4.3
Phenobarbital / primidone	Cobicistat	contraindicated	Phenobarbital lowers cobicistat and the boosted PI.	Rezolsta §4.3
Phenobarbital / primidone	Bictegravir	avoid	Phenobarbital lowers bictegravir.	Biktarvy §4.5
Phenobarbital / primidone	Dolutegravir	avoid	Phenobarbital lowers dolutegravir.	Tivicay §4.5
Phenytoin / fosphenytoin	Rilpivirine	contraindicated	Phenytoin lowers rilpivirine.	Edurant §4.3
Phenytoin / fosphenytoin	Doravirine	contraindicated	Phenytoin lowers doravirine.	Pifeltro §4.3
Phenytoin / fosphenytoin	Cabotegravir	contraindicated	Phenytoin lowers cabotegravir.	Vocabria tablets §4.3
Phenytoin / fosphenytoin	Cobicistat	contraindicated	Phenytoin lowers cobicistat and the boosted PI.	Rezolsta §4.3
Phenytoin / fosphenytoin	Bictegravir	avoid	Phenytoin lowers bictegravir exposure.	Biktarvy §4.5
Phenytoin / fosphenytoin	Dolutegravir	avoid	Phenytoin lowers dolutegravir exposure.	Tivicay §4.5
Phenytoin / fosphenytoin	Tenofovir alafenamide	avoid	Phenytoin lowers tenofovir alafenamide.	Descovy §4.5
Pimozide or lurasidone	Ritonavir	contraindicated	Ritonavir raises pimozide/lurasidone.	Norvir §4.3
Pimozide or lurasidone	Cobicistat	contraindicated	Cobicistat raises pimozide/lurasidone.	Rezolsta §4.3
Pimozide or lurasidone	Efavirenz	contraindicated	Efavirenz with pimozide — risk of arrhythmia.	Efavirenz 600 mg (generic) §4.3
Proton pump inhibitor (e.g. omeprazole)	Rilpivirine	contraindicated	Proton pump inhibitors raise gastric pH and markedly lower oral rilpivirine absorption. Applies to oral dosing only.	Edurant §4.3
Proton pump inhibitor (e.g. omeprazole)	Atazanavir	avoid	Proton pump inhibitors markedly lower atazanavir absorption.	Atazanavir 300 mg (generic) §4.5
Quetiapine	Ritonavir	contraindicated	Ritonavir raises quetiapine (coma reported).	Norvir §4.3
Quetiapine	Cobicistat	contraindicated	Cobicistat raises quetiapine.	Rezolsta §4.3
Rifabutin	Bictegravir	avoid	Rifabutin lowers bictegravir exposure.	Biktarvy §4.5
Rifabutin	Cabotegravir	avoid	Rifabutin lowers cabotegravir exposure; concomitant use should be avoided.	Vocabria injection §4.5
Rifabutin	Tenofovir alafenamide	avoid	Rifabutin lowers tenofovir alafenamide exposure.	Descovy §4.5
Rifabutin	Doravirine	adjust	Rifabutin lowers doravirine exposure. Doravirine 100 mg twice daily (about 12 h apart) with rifabutin	Pifeltro §4.2
Rifabutin	Rilpivirine	adjust	Rifabutin lowers rilpivirine exposure.	Edurant §4.2
Rifabutin	Ritonavir	adjust	Ritonavir-boosted PIs raise rifabutin (and its active metabolite).	Prezista 800 mg §4.5
Rifampicin	Bictegravir	contraindicated	Rifampicin markedly lowers bictegravir exposure.	Biktarvy §4.3
Rifampicin	Rilpivirine	contraindicated	Rifampicin markedly lowers rilpivirine exposure.	Edurant §4.3
Rifampicin	Doravirine	contraindicated	Strong CYP3A induction by rifampicin markedly lowers doravirine.	Pifeltro §4.3
Rifampicin	Cabotegravir	contraindicated	Rifampicin markedly lowers cabotegravir exposure.	Vocabria tablets §4.3
Rifampicin	Darunavir	contraindicated	Rifampicin markedly lowers darunavir exposure.	Prezista 800 mg §4.3
Rifampicin	Atazanavir	contraindicated	Rifampicin markedly lowers atazanavir exposure.	Atazanavir 300 mg (generic) §4.3
Rifampicin	Tenofovir alafenamide	avoid	Rifampicin, a P-gp inducer, lowers tenofovir alafenamide exposure.	Descovy §4.5
Rifampicin	Dolutegravir	adjust	Rifampicin lowers dolutegravir exposure; the dose must be doubled. Dolutegravir 50 mg twice daily while on rifampicin and for 2 weeks after (not with integrase resistance) — with Dovato/Triumeq add a separate Tivicay 50 mg dose about 12 hours later	Tivicay §4.2
Rifampicin	Raltegravir	adjust	Rifampicin lowers raltegravir exposure (AUC ↓40%); if co-administration is unavoidable the SmPC says doubling the dose can be considered. Consider doubling raltegravir to 800 mg twice daily with rifampicin (not the 1,200 mg once-daily regimen)	Isentress §4.5
Rifampicin	Efavirenz	monitor	Efavirenz 600 mg can be given with rifampicin (efavirenz exposure falls modestly; the SmPC allows a dose increase in patients ≥50 kg).	Efavirenz 600 mg (generic) §4.5
Rifapentine	Rilpivirine	contraindicated	Rifapentine markedly lowers rilpivirine.	Edurant §4.3
Rifapentine	Doravirine	contraindicated	Rifapentine markedly lowers doravirine.	Pifeltro §4.3
Rifapentine	Cabotegravir	contraindicated	Rifapentine markedly lowers cabotegravir.	Vocabria tablets §4.3
Rifapentine	Bictegravir	avoid	Rifapentine lowers bictegravir; co-administration is not recommended.	Biktarvy §4.5
Rifapentine	Darunavir	avoid	Rifapentine with boosted darunavir is not recommended.	Prezista 800 mg §4.5
Rifapentine	Tenofovir alafenamide	avoid	Rifapentine lowers tenofovir alafenamide; not recommended.	Descovy §4.5
Salmeterol	Ritonavir	avoid	Ritonavir raises salmeterol (QT prolongation, palpitations).	Norvir §4.5
Salmeterol	Cobicistat	avoid	Cobicistat raises salmeterol.	Rezolsta §4.5
Sildenafil for pulmonary arterial hypertension	Ritonavir	contraindicated	Ritonavir raises sildenafil (PAH dosing contraindicated).	Norvir §4.3
Sildenafil for pulmonary arterial hypertension	Cobicistat	contraindicated	Cobicistat raises sildenafil (PAH dosing contraindicated).	Rezolsta §4.3
Simvastatin or lovastatin	Ritonavir	contraindicated	Ritonavir markedly raises simvastatin/lovastatin (rhabdomyolysis).	Norvir §4.3
Simvastatin or lovastatin	Cobicistat	contraindicated	Cobicistat markedly raises simvastatin/lovastatin.	Rezolsta §4.3
Sofosbuvir/velpatasvir (Epclusa)	Efavirenz	avoid	Efavirenz lowers velpatasvir.	Efavirenz 600 mg (generic) §4.5
Sofosbuvir/velpatasvir (Epclusa)	Tenofovir disoproxil	monitor	Sofosbuvir/velpatasvir raises tenofovir — monitor renal function.	Viread §4.5
St John's wort	Bictegravir	contraindicated	St John's wort induces bictegravir metabolism.	Biktarvy §4.3
St John's wort	Rilpivirine	contraindicated	St John's wort lowers rilpivirine.	Edurant §4.3
St John's wort	Doravirine	contraindicated	St John's wort lowers doravirine.	Pifeltro §4.3
St John's wort	Darunavir	contraindicated	St John's wort lowers darunavir.	Prezista 800 mg §4.3
St John's wort	Atazanavir	contraindicated	St John's wort lowers atazanavir.	Atazanavir 300 mg (generic) §4.3
St John's wort	Efavirenz	contraindicated	St John's wort lowers efavirenz.	Efavirenz 600 mg (generic) §4.3
St John's wort	Dolutegravir	avoid	St John's wort lowers dolutegravir exposure.	Tivicay §4.5
St John's wort	Tenofovir alafenamide	avoid	St John's wort lowers tenofovir alafenamide.	Descovy §4.5
Corticosteroid injections (e.g. triamcinolone, methylprednisolone)	Darunavir	avoid	Boosted darunavir raises CYP3A-metabolised corticosteroids by any route (Cushing's syndrome, adrenal suppression).	Prezista 800 mg §4.5
Tacrolimus or ciclosporin	Darunavir	adjust	Boosted darunavir markedly raises tacrolimus/ciclosporin. Therapeutic drug monitoring of tacrolimus/ciclosporin is mandatory with boosted darunavir	Prezista 800 mg §4.5
Tacrolimus or ciclosporin	Efavirenz	adjust	Efavirenz lowers tacrolimus/ciclosporin. Monitor immunosuppressant levels for at least 2 weeks after starting or stopping efavirenz	Efavirenz 600 mg (generic) §4.5
Ticagrelor or clopidogrel	Cobicistat	contraindicated	Boosting raises ticagrelor; clopidogrel activation is reduced.	Rezolsta §4.3
Ticagrelor or clopidogrel	Ritonavir	avoid	Ritonavir-boosted darunavir raises ticagrelor and reduces clopidogrel activation.	Prezista 800 mg §4.5
Voriconazole	Darunavir	avoid	Voriconazole should not be combined with boosted darunavir unless the benefit/risk assessment justifies it.	Prezista 800 mg §4.5
Voriconazole	Cobicistat	avoid	Voriconazole should not be combined with darunavir/cobicistat unless justified.	Rezolsta §4.5
Voriconazole	Efavirenz	adjust	Efavirenz and voriconazole interact in both directions. Voriconazole 400 mg twice daily and efavirenz 300 mg once daily	Efavirenz 600 mg (generic) §4.5