Sadvtreatmentcentres.com2

If the client is on ANY of these drugs OR has any of the health conditions listed, consult a MD.
If there are concerns re: interactions with any drug not listed, consult a Pharmacist/HIV Expert. CONTRAINDICATED
Use with CAUTION
Antiarrhythmics ▪ Flecainide (Tambocor®) Antiarrhythmics ▪ Amiodarone (Cordarone®) Antibiotics ▪ Rifampin (Rifadin®, Rofact®) Antihistamines ▪ Astemizole (Hismanol®) Antibiotics ▪ Clarithromycin (Biaxin®) Ergot Derivatives ▪ Bellergal Spacetabs® Anticonvulsant ▪ Carbamazepine (Tegretol®) Antifungals ▪ Itraconazole (Sporanox®) GI Mortality Agents ▪ Cisapride (Propulsid®)3 Herbal Products ▪ St. John’s Wort (Hypericum perforatum) Calcium Channel Blockers ▪ Felodipine (Plendil/Renedil®) ▪ Nicardipine (Cardene®)▪ Nifedipine (Adalat®) Corticosteroids ▪ Dexamethasone (Decadron®) Immunosuppressants ▪ Cyclosporine (Neoral®, Sandimmune®) Inhaled Steroids ▪ Fluticasone (Flonase®, Advair®) PDE5 Inhibitors ▪ Sildenafil (Viagra®) ▪ Tadalafil (e.g., Cialis®)▪ Vardenafil (Levitra®) Oral/Patch Contraceptive ▪ Norethindrone Statins ▪ Atorvastatin (Lipitor®) or Rosuvastatin 1 History of hepatitis does not rule out HIV PEP. MD and/or HIV Expert consultation recommended. Possible contraindication in the event of acute symptomatic illness or severely elevated liver enzymes (> 5X normal). Dosage adjustments may be necessary. 2 Not all drugs within each drug class are contraindiated - only drugs listed above are contraindicated when co-administered with either Combivir® or Kaletra®.
3 Product no longer available in Canada, only available in the United States.
4 If it is suspected that the client is emotionally unstable and/or at risk of overdosing, it is recommended to use Combivir® alone.
If the client is on ANY of these drugs OR has any of the health conditions listed, consult a MD.
If there are concerns re: interactions with any drug not listed, consult a Pharmacist/HIV Expert. CONTRAINDICATED
Use with CAUTION
Health Abnromally low neutrophil count (< 0.75 x 109/L) ir® Conditions Abnormally low hemoglobin levels (< 75 g/L)
Pancreatitis (history OR risk factors) 5Kidney problems ▪ Trimethoprim-sulfamethoxazole (Septra®) b Precautions
▪ Amphotericin B▪ Fluconazole (Diflucan®) ▪ Stavudine (Zerit®)▪ Zalcitabine (Hivid®) ▪ Interferon alpha (Roferon®-A, Intron® A, 1 History of hepatitis does not rule out HIV PEP. MD and/or HIV Expert consultation recommended. Possible contraindication in the event of acute symptomatic illness or severely elevated liver enzymes (> 5X normal). Dosage adjustments may be necessary. 2 Not all drugs within each drug class are contraindiated - only drugs listed above are contraindicated when co-administered with either Combivir® or Kaletra®.
3 Product no longer available in Canada, only available in the United States.
4 If it is suspected that the client is emotionally unstable and/or at risk of overdosing, it is recommended to use Combivir® alone.
5 Increased concern in paediatric clients.
Non-essential medications, alternate therapy, vitamins and recreational drug use should be discontinued during the HIV PEP regimen (e.g., herbal mood enhancers/sleep aids such as 5-hydroxy-L-triptophan (5HTP or Tryptophan); multi-vitamins).
Kaletra® can decrease the effectiveness of long-term use birth control pills. Barrier form contraceptive (e.g., condom) should be used for 28 days + 2 months.
The use of Combivir® and Kaletra® during pregnancy has not been extensively studied. IF a woman is pregnant: HIV PEP drugs are potentially teratogenic in the 1st trimester (often avoided during this period).
Since Kaletra is a substrate and potent CYP3A4 inhibitor, caution should be used when co-administering Kaletra and CYP3A4 enzyme inducers, inhibitors, or substrates with narrow therapeutic indices. If in doubt, please consult with an HIV Expert or Pharmacist. STOP HIV PEP if: Grade 4 AE; Hemoglobin <80 g/L; Absolute Neutrophil < 0.5 x 109/L; Platelet Count <20,000 cells/µL; AST / ALT / ALP
/ Bilirubin > 5X upper limit of normal.

Source: http://sadvtreatmentcentres.com/files/contraindicationsquickreferencechart.pdf