Date of report: 06 May 2019
Reported case interaction between
Rilpivirine and Omeprazol
Rilpivirine and Omeprazol
Drugs suspected to be involved in the DDI
Drug A
Rilpivirine
(Victim)
Daily Dose
25
(mg)
Dose adjustment performed
No
Administration Route
Oral
Start date
Jan. 1, 2014
End date
March 1, 2019
Drug B
Omeprazol
(Perpetrator)
Daily Dose
20
(mg)
Dose adjustment performed
No
Administration Route
Oral
Start date
Oct. 1, 2018
End date
Ongoing
Complete list of drugs taken by the patient
Antiretroviral treatment
Rilpivirine
Abacavir/Lamivudine
Complete list of all comedications taken by the patient, included that involved in the DDI
Atrovastatin
Clinical case description
Gender
Male
Age
57
eGFR (mL/min)
>60
Liver function impairment
No
Description
HIV patient on cART with rilpivirine plus abacavir/lamivudine; diagnosed with gastroesophageal reflux disease and treated with famotidine 40 mg (separated 12 hours from RPV).
In October 2018 the patient visited another specialist and famotidine was changed to omeprazol (20 mg qd). Rilpivirine was maintained.
In March 2019 the patient was free of GI symptoms and HIV viral load remained <40 copies/mL. However, due to potential decrease in rilpivirine concentrations, cART is changed to raltegravir plus abacavir/lamivudine.
Outcome
No unwanted outcome
Editorial Comment
Rilpivirine should not be co-administered with omeprazol as significant decreases in rilpivirine plasma concentrations may occur due to gastric pH increase, which may result in loss of virologic response and possible resistance to rilpivirine or to the class of NNRTIs.