Proton pump inhibitors Delavirdine

Dihydropyridine Ca++ channel antagonists H2 blockers/proton pump inhibitors Decreased absorption of delavirdine Avoid... 

Delavirdine Due to its shorter tj, d rapid emergence of resistance, delavirdine is the least used of the NNRTIs. Its absorption is best at acid pH and may be decreased by histamine Hj receptor antagonists or proton pump inhibitors. It is cleared predominantly by CYP3A4 and has an elimination tj 6 hours. It should be avoided with CYP3A4 substrates with a narrow therapeutic index and not combined with potent inducers of CYP3A4 (e.g., carbamazepine, phenobarbital, phenytoin, rifabutin, and rifampin). 

A4 Barbiturates, carbamazepine, corticosteroids, efavirenz, phenytoin, rifampin, troglitazone Antiarrhythmics, antidepressants, azole antifungals, benzc iazepines, calcium channel blockers, cyclosporine, delavirdine, doxorubicin, efavirenz, erythromycin, estrogens, HIV protease inhibitors, nefazodone, paclitaxel, proton pump inhibitors, HMG-CoA reductase inhibitors, rifabutin, rifampin, sildenafil, SSRIs, tamoxifen, trazodone, vinca anticancer agents... 

Antacids roughly halve the AUC of delavirdine, and the 112-receptor antagonists or proton pump inhibitors would be expected to interact similarly. Aluminium/magnesium antacids do not interact to a clinically relevant extent with efavirenz or nevirapine, and famotidine does not alter the absorption of efavirenz. 

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