Significantly decreased plasma conc & loss of therapeutic effect of PIs & certain reverse transcriptase inhibitors. Reduced effectiveness of hormonal contraceptives. Increased metabolism & decreased activity of antiarrhythmics (eg, disopyramide, mexiletine, quinidine, tocainide); antibiotics [eg, chloramphenicol, clarithromycin, dapsone, doxycycline; fluoroquinolones (eg, ciprofloxacin)]; oral anticoagulants (eg, warfarin); anticonvulsants (eg, phenytoin); antimalarials (eg, quinine); azole antifungals (eg, fluconazole, itraconazole, ketoconazole); antipsychotics (eg, haloperidol); barbiturates (eg, phenobarb); benzodiazepines (eg, diazepam); β-blockers (eg, propanolol); Ca channel blockers (eg, diltiazem, nifedipine, verapamil); cardiac glycoside prep (eg, digoxin); corticosteroids (eg, prednisone); fibrates (eg, clofibrate); oral hypoglycemics [eg, sulfonylureas (eg, glyburide, glipizide)]; hormonal contraceptives/progestins (ethinyl estradiol, levonorgestrel); immunosuppressants (eg, cyclosporine, tacrolimus); methylxanthines (eg, theophylline); narcotic analgesics (eg, methadone); phosphodiesterase-5 inhibitors (eg, sildenafil); thyroid prep (eg, levothyroxine); TCAs (eg, amitriptyline, nortriptyline). Drug displacement interactions may also occur.
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