Módulo 1 – Curso pós-graduado – VIH e Envelhecimento

Drug-drug Interactions and Polypharmacy in Older HIV Persons

Drug interactions and management of HIV infection

Mensagens-chave

  • Antiretroviral drugs can cause clinically relevant drug interactions, which may occur by inhibition or induction of enzymes or transporters, or by changes in the absorption mechanisms;
  • With increasing age, HIV-infected patients will use an increasing number of co-medications, with greater diversity of pharmacological classes and less studied interactions.
  • Whenever possible, antiretroviral drugs with less potential for interactions should be used, such as RAL, DTG and RPV.
  • The management of drug interactions can be optimized through a strategy that includes an evaluation of interactions and inherent mechanisms, evaluation of the adjustment of co-medication or, where that is not possible, the adjustment of antiretrovirals, the clarification with a clinical pharmacologist of unusual situations and the monitoring of treatment – a six steps strategy.
  • Therapeutic drug monitoring can be an option when there is suspected interaction, especially in older patients.
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