Efavirenz Fluoxetine

Actinomycin-D, amitriptyline, amoxapine, amprenavir, apomorphine atazanavir, citalopram, clomipramine, desipramine, dothiepin, doxepin, efavirenz, fluoxetine, imipramine, indinavir, lopinavir, maprotiline, meropenem, mianserin, nelfinavir, nevirapine, norfluoxetine, nortriptyline, pergolide, paroxetine, procarbazine, ritonavir, sertraline, saquinavir, trimipramine, vincristine, zidovudine... 

SSRIs NNRTIs - EFAVIRENZ 1. Possible efficacy and adverse effects, including serotonin syndrome, with fluoxetine 2. Possible 1 efficacy with sertraline 1. Uncertain mechanism possibly bioavailability 2. CYP2B6 contributed most to the demethyla-tion of sertraline, with lesser contributions from CYP2C19, CYP2C9, CYP3A4 and CYP2D6 1. Use with caution consider l dose of fluoxetine 2. Watch for therapeutic failure, and advise patients to report persistence or lack of improvement of symptoms of depression. dose of sertraline as required titrate to clinical response... 

BUPROPION 1. ANTICANCER DRUGS - thiotepa 2. ANTIDEPRESSANTS-fluoxetine, fluvoxamine, paroxetine, sertraline 3. ANTIVIRALS - efavirenz, protease inhibitors t plasma concentrations of bupropion and risk of adverse effects Inhibition of CYP2B6 Warn patients about adverse effects and use alternatives when possible. Avoid co-administration of bupropion with protease inhibitors. Co-adminis-ter efavirenz and bupropion with caution. A retrospective study showed that two patients received a combination without reported adverse effects. Potential T risk of seizures... 

Clinically important, potentially hazardous interactions with alcohol, aprepitant, clarithromycin, CNS depressants, delavirdine, digoxin, efavirenz, fluconazole, fluoxetine, fluvoxamine, grapefruit juice, indinavir, itraconazole, ivermectin, kava, ketoconazole, propoxyphene, ritonavir, saquinavir, St John s wort... 

Scheme 4.12 Examples of fluorine

A case of the serotonin syndrome occurred in a woman taking fluoxetine when efavirenz was added. Nevirapine decreased fluoxetine plasma levels, but fluvoxamine increased nevirapine levels. 

A case of serotonin syndrome in a woman taking fluoxetine coincided with the start of a new antiretroviral regimen including efavirenz. Symptoms resolved when the fluoxetine dose was halved. It was suggested that efavirenz inhibited the metabolism of fluoxetine. Until further information is available, caution may be warranted if both drugs are given. 

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