This section of the website is for UK healthcare professionals only. If you are not a healthcare professional, please click here.
This section of the website is for UK healthcare professionals only. If you are not a healthcare professional, please click here.

Doravirine safety: drug-drug interactions (DDIs)

DELSTRIGO® Prescribing Information (Great Britain) & Prescribing Information (Northern Ireland) [External links]
PIFELTRO® Prescribing Information (Great Britain) & Prescribing Information (Northern Ireland) [External links]

Doravirine can be used with a variety of non-HIV medications

  • Doravirine is primarily metabolised by CYP3A1,2
  • It can be co-administered with studied acid-reducing agents without dosing restrictions1,2,3
  • Doravirine can also be co-administered with drugs used to treat a range of common co-morbidities such as anti-diabetics and Lipid lowering agents4

Please refer to the relevant Summary of Product Characteristics for full details of potential interactions and contraindications before prescribing.

  DELSTRIGO2 PIFELTRO1
Proton pump inhibitors
Pantoprazole, omeprazole
Acid-modifying medications
Aluminium hydroxide/magnesium hydroxide/simethicone-containing antacids
Statins
Atorvastatin, rosuvastatin, simvastatin
Antihyperglycemics
Metformin
Oral contraceptives
Ethinyl estradiol, levonorgestrel
Hepatitis C antiviral agents
Elbasvir/grazoprevir, daclatasvir

Sofosbuvir/ledipasvir, sofosbuvir/velpatasvir

a

Benzodiazepines
Midazolam
Opioid analgesics
Methadone, buprenorphine
Azole antifungal agents
Ketoconazole, fluconazole, itraconazole, posaconazole, voriconazole
b b
Dose adjustment required:c Antimycobacterial
Rifabutin

d

d
Download
  1. Monitor for adverse reactions associated with TDF.
  2. Concomitant use of DELSTRIGO or PIFELTRO with azole antifungal agents may cause an increase in the plasma concentrations of doravirine (inhibition of CYP3A enzymes). No dose adjustment is required.
  3. Co-administration of doravirine with other moderate CYP3A inducers has not been evaluated, but decreased doravirine concentrations are expected. If co-administration with other moderate CYP3A inducers (e.g. dabrafenib, lesinurad, bosentan, thioridazine, nafcillin, modafinil, telotristat ethyl) cannot be avoided, one 100 mg tablet of doravirine should be taken daily, approximately 12 hours after the dose of DELSTRIGO or PIFELTRO.
  4. Concomitant use of DELSTRIGO or PIFELTRO with rifabutin may cause a decrease in the plasma concentrations of doravirine (induction of CYP3A enzymes). If DELSTRIGO is co-administered with rifabutin, one tablet of PIFELTRO should be taken approximately 12 hours after the dose of DELSTRIGO. If PIFELTRO is co-administered with rifabutin, one tablet of PIFELTRO should be taken twice daily (approximately 12 hours apart).
Contraindicationse
PIFELTRO may be used with many HIV ARVs

View other MSD HIV products…

References

  1. Pifeltro Summary of Product Characteristics
  2. Delstrigo Summary of product characteristics
  3. Khalilieh S et al. Co-administration of doravirine with an aluminium/magnesium containing antacid or pantoprazole, a proton pump inhibitor, does not have a clinically meaningful effect on doravirine pharmacokinetics. Presented at 9th IAS Conference on HIV Science, 23-26 July 2017, Paris. Available at: http://programme.ias2017.org/PAGMaterial/eposters/3996.pdf. Accessed 18 July 2018
  4. HIV Drug Interactions, University of Liverpool: http://www.hiv-druginteractions.org/

Supporting documentation

DELSTRIGO® Prescribing Information (Great Britain) & Prescribing Information (Northern Ireland)
PIFELTRO® Prescribing Information (Great Britain) & Prescribing Information (Northern Ireland)
By clicking the links above you will leave the MSD Connect website and be taken to the emc PI portal website

GB-DOR-00090 | Date of Preparation: June 2020