AIDS TREATMENT NEWS alerts May 18, 2004
John S. James

Drug interactions require special precautions when prescription drugs are combined with certain other drugs, herbal treatments, or even some foods. This is why your doctor needs to know everything you are taking. Here are some Web sites, and a printed document, where you can check your HIV treatments for some of the most important drug interactions.

Some interactions mean that the drugs cannot be used together at all. More often, however, the combination can still be used, but one or both of the doses needs to be adjusted (either up or down, depending on how the drugs interact).

Caution: These sources seem credible, but they may not include all the known interactions. And clearly there are unknown ones as well, since interactions continue to be discovered even for drugs already in wide use. So if a drug combination does not show up on one of these sources, that does not necessarily mean that no interactions exist.

AIDSmeds.com

On the home page click the link 'CHECK MY MEDS' for drug/drug and drug/food interactions. This drug-interaction calculator lets you enter your regimen and then test it for restrictions and problems you should know about. When entering the drugs you can use either brand names (such as Videx), generic names (such as didanosine), or common names (ddI).

If you want, you can set up an account on the site and save your regimen there, to avoid having to re-enter all the drugs if you run tests again in the future.

This site is fairly easy to use, and gives plenty of information about food restrictions, drug/drug interactions, and food/drug interactions all in one place.

HIV InSite, University of California

On the home, page click 'Medical'. Then click 'Drug Interactions Database' in the column on the left. Then you get three choices. You can pick an FDA-approved antiretroviral and see all the interactions with it that are in the database. Or you can pick any drug in the database and get all of its interactions with the antiretrovirals. Or you can pick any of about 20 drug classes and see their interactions with antiretrovirals.

Liverpool HIV Pharmacology Group

This site has many recent reports on professional conferences relevant to drug interactions. But the site itself can be confusing to patients. On the home page, click 'DRUG INTERACTION CHARTS', and then click 'Interaction Charts' again. Follow the instructions to enter your regimen.

Step 2, "Choose Combination Class(es)" requires the user to know and enter all the classes in order to be able to select the individual drugs later. Note that the different classes of antiretrovirals, as well as many other classes of prescriptions drugs, are included here.

Finally, you can click on various symbols to see some of the interactions. In general, less information is provided in these text summaries than on the sites listed above.

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents

(document, not Web site)

This is not a Web site but a printed document (of the U.S. government guidelines for HIV treatment), so you do not need a computer to use it. If you do have a computer, download a current copy of the guidelines from http://www.aidsinfo.nih.gov/ in order to be sure you have the current version. These guidelines may be revised several times a year.

If you do not have a computer you can order a printed copy by phone or mail; they are mailed to U.S. addresses only. By phone, call 800-448-0440 Monday through Friday noon to 5 p.m. Eastern time. By mail, send your request to AIDSinfo, PO Box 6303, Rockville, MD 20849; be sure and ask for the "adult and adolescent" guidelines, as there are many other guidelines as well. Phone is preferred, because it takes an extra week for mailed requests to arrive at the right office. Those who do have a computer can also order a printed copy through the Web site above.

See especially the tables at the end of the document. In the current (March 2004) guidelines, see particularly Table 14 ("Antiretroviral Regimens or Components That Should Not Be Offered At Any Time") through Table 23 ("HIV-Related Drugs with Overlapping Toxicities"). These 11 tables may change, and their numbering may change, in future editions of the guidelines.

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