Prevalence and nature of potential drug-drug interactions among hospitalized HIV patients presenting with suspected meningitis in Uganda

Eneh, Prosperity C.; Hullsiek, Katherine Huppler; Kiiza, Daniel; Rhein, Joshua; Meya, David B.; Boulware, David R.; Nicol, Melanie R.

doi:10.1186/s12879-020-05296-w

Table 2 Most occurring potential drug-drug interaction for each level of severity

From: Prevalence and nature of potential drug-drug interactions among hospitalized HIV patients presenting with suspected meningitis in Uganda

Severity^a	Drug 1	Drug 2	% pDDI overall^b	Level of evidence^c	Proposed effect summary
Contraindicated
	Fluconazole	Ondansetron	3.6	Fair	Risk of QT interval prolongation
	Fluconazole	Haloperidol	2.8	Fair	Increased haloperidol exposure, risk of QT interval prolongation
	Fluconazole	Ritonavir	1.1	Fair	Increased ritonavir exposure, risk of QT interval prolongation
	Artane	Potassium (oral)	0.8	Fair	Gastrointestinal lesions
	Fluconazole	Atazanavir	0.8	Fair	Increased atazanavir exposure, risk of QT interval prolongation
	Fluconazole	Artemether- lumefantrine	0.7	Fair	Risk of QT interval prolongation
	Dihydroartemisinin-piperaquine	Efavirenz	0.2	Fair	Risk of QT interval prolongation
	Fluconazole	Dihydroartemisinin-piperaquine	0.2	Fair	Risk of QT interval prolongation
	Haloperidol	Metoclopramide	0.2	Fair	Increased extrapyramidal reactions and neuroleptic malignant syndrome
	Fluconazole	Quinine	0.1	Fair	Increased quinine levels, risk of QT interval prolongation
Major
	Co-trimoxazole	Fluconazole	18	Fair	Cardiotoxicity (QT prolongation, torsades)
	Efavirenz	Fluconazole	8.6	Fair	Risk of QT interval prolongation
	Codeine	Fluconazole	4.8	Fair	Increased codeine concentration
	Isoniazid	Rifampin	4.5	Good	Hepatotoxicity
	Co-trimoxazole	Haloperidol	2.4	Fair	Cardiotoxicity (QT prolongation, torsades)
	Pyrazinamide	Rifampin	2.4	Good	Hepatotoxicity
	Fluconazole	Metronidazole	2.3	Fair	Risk of QT interval prolongation and arrhythmias
	Efavirenz	Ondansetron	1.3	Fair	QT interval prolongation
	Codeine	Efavirenz	1.1	Fair	Decreased codeine efficacy
	Codeine	Metoclopramide	1.1	Fair	Increased CNS depression
	Azithromycin	Fluconazole	1.1	Fair	Risk of QT interval prolongation
	Ciprofloxacin	Fluconazole	1.1	Fair	Risk of QT interval prolongation
	Fluconazole	Tramadol	0.9	Fair	Increased tramadol exposure and increased risk of respiratory depression
	Acetaminophen	Isoniazid	0.9	Excellent	Hepatotoxicity
	Efavirenz	Rifampin	0.9	Fair	Decreased serum efavirenz concentration
Moderate
	Fluconazole	Zidovudine	4.2	Good	Increased zidovudine serum concentration
	Fluconazole	Rifampin	2.2	Excellent	Decreased fluconazole serum concentration
	Artane	Haloperidol	1.2	Good	Excessive anticholinergic effects
	Acetaminophen	Zidovudine	0.9	Good	Hepatotoxicity (acetaminophen driven)
Minor
	Co-trimoxazole	Zidovudine	3.6	Good	Increased zidovudine serum concentration

^a Severity classification for clinical purposes per IBM Micromedex DRUGDEX® database definitions
^b Percent of overall pDDI for study, % reported as (n/ 4582 total pDDI events) * 100
^c Strength of scientific data for the interaction per IBM Micromedex DRUGDEX® database; (i) excellent – clearly documented well controlled studies support the interaction; (ii) good – studies strongly suggest that interaction exists however there are not well controlled studies; (iii) fair – available evidence is poor but clinicians suspect the interaction exists based on pharmacology or the available evidence is good for a pharmacologically similar drug; and (iv) unknown – interaction documentation is unknown

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ISSN: 1471-2334

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