Results

Mutations: I5I, I5V, K20K, K20R, V35I, M41L, E53D, K101Q, Q102K, K122E, I135K I135R, C162S, S163T, F171F, F171V, Q174N, V179I, T215E, V245T, A272P, V276I, R277K, Q278H, Q278N, K281K, K281R, D324E, G333E, Q334N, K358R, G359S, A371V, K374K, K374R, I375V, A376T, K385R, K390R, A400T, L10V, I13V, K14K, K14R, I15V, D30N, E35D, M36I, N37D, L63P, I72V, V75I, N88D, D6E, K14R, N27G, N27S, V32I, L45Q, V72I, L101I, V113I, K136Q, I204I, I204V, D253D, D253N
Comorbidities: Diarrhea and GI Symptoms, Peripheral Neuropathy, Depression
Comedications: Dapsone
Treatment history: LPV/r (Lopinavir-ritonavir/Kaletra) , FPV/r (Fosamprenavir-ritonavir/Lexiva and Norvir) , ATV (Atazanavir/Reyataz) , DRV (Darunavir/Prezista) , RAL (Raltegravir/Isentress) , DTG (Dolutegravir/Tivicay) , BIC (Bictegravir/Biktarvy) , TDF/FTC (Truvada) , ABC/3TC (Epzicom) , EVG/c/TAF/FTC (Genvoya)
Current regimen: None
Adherence: No options selected
CD4: ≤ 100
Viral load: High (100,000 - 500,000)
HLA-B5701: Negative
Tropism: Unknown
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Regimen Weighted Score Active Drugs Total Pills Frequency (x/day)
DRV/r+TAF/FTC 10.65 1.33 5 2
DTG+TAF/FTC 5.65 1.67 2 1
BIC/TAF/FTC 6.65 1.67 1 1
DTG+DRV/r 7.2 1.67 5 2
DRV/r+DOR 9.2 1.67 5 2
RAL+DRV/r 9.2 1.67 6 2
RAL+TAF/FTC 9.65 1.67 3 1
DOR+TAF/FTC 9.8 1.67 2 1
EVG/c/TAF/FTC 10.15 1.67 1 1
DRV/r+ETR 10.65 1.67 6 2
IBA+DRV/r 10.7 1.67 4 2
DRV/r+RPV 11.05 1.67 5 2
FOS+DRV/r 11.29 1.67 6 2
DRV/r+EFV 11.7 1.67 5 2
ETR+TAF/FTC 12.2 1.67 3 2

Report

Preferred regimen based on the HIV-ASSIST algorithm: DTG+DOR+TAF/FTC

DTG+DOR+TAF/FTC had the lowest weighted score (4.46) among all regimens HIV-ASSIST evaluated. In general, lower HIV-ASSIST weighted scores are considered preferable with respect to achieving viral suppression and maximizing tolerability. Your patient may have other considerations we did not factor and this report should not be considered a guarantee of likely success with this patient. Please use clinical judgement in making final ARV selections. Other regimens you may wish to consider are listed below. A full list of ARV regimens analyzed by the HIV-ASSIST algorithm can be found by clicking the Expert Tab above.

Regimen Weighted Score Active Drugs Total Pills Frequency (x/day)
DTG+DOR+TAF/FTC 4.46 2.67 3 1

The rationale behind why this regimen was chosen by our algorithm as the most appropriate is shown below:

Other highly ranked regimens

Other highly ranked regimens based on the HIV-ASSIST algorithm are shown below. For full details on these regimens, please click on the Expert Tab above.

Regimen Weighted Score Active Drugs Total Pills Frequency (x/day)
DTG+DRV/r+TAF/FTC 4.8 2.33 6 2
DTG+RPV/TAF/FTC [Your preferred regimen] 4.86 2.67 2 1
DTG+DRV/r+DOR 4.91 2.67 6 2
DTG+DOR 5.06 2 2 1

What about your originally preferred regimen: DTG+RPV/TAF/FTC

The rationale behind why your preferred regimen was not chosen by our algorithm as the top is shown below:

Mutations

Based on the Stanford Database, we assign penalties to various regimens based on inputted (i.e., genotypic) and assumed archived mutations. We consider drugs with summed mutation scores between 10 and 29 to have low-level resistance, scores between 30 and 59 to have intermediate-level resistance, and scores above 60 to have high-level resistance.

* signifies an assumed archived mutation based on prior treatment experience.
NRTI Mutation(s) 3TC FTC ABC TAF TDF AZT D4T DDI
M41L 0 0 5 5 5 15 15 10
T215E 0 0 5 5 5 20 20 10
V75I 5 5 5 5 5 5 5 5
M184V* 60 60 15 -10 -10 -10 -10 10
M41L + T215ACDEILNSV 0 0 5 5 5 5 5 5
Total 65 65 35 10 10 35 35 40
NNRTI Mutation(s) EFV ETR RPV NVP DOR
Total 0 0 0 0 0
PI Mutation(s) LPVr FPVr TPVr SQVr IDVr NFV ATVr ATVc ATV DRV DRVr DRVc
D30N 0 0 0 0 0 60 0 0 0 0 0 0
N88D 0 0 0 10 0 60 10 10 10 0 0 0
V32I 15 30 5 0 15 15 15 15 15 15 15 15
Total 15 30 5 10 15 135 25 25 25 15 15 15
INSTI Mutation(s) RAL EVGc DTG BIC CAB
Total 0 0 0 0 0
EI Mutation(s) MVC IBA FOS
Total 0 0 0

Comorbidities, Side Effects, and Pregnancy Interactions

HIV-ASSIST incorporates a mathematical penalty into our algorithms for ARVs that are less preferred due to comorbidities or side-effects, based on recommendations from DHHS guidelines and HIV-ASSIST clinician and pharmacist expertise. In general, higher penalties suggest that the listed ARV is less favored in the presence of the stated comorbidity or side effect.

Penalty:
1
HIV-ASSIST Notes:
AZT can cause pancreatitis and severe nausea.
Penalty:
1
HIV-ASSIST Notes:
ddI can cause pancreatitis and severe nausea.
Penalty:
1
HIV-ASSIST Notes:
Up to 30% of patients using LPV will experience diarrhea.
Penalty:
1
HIV-ASSIST Notes:
Hyperbilirubinemia and diarrhea are common side effects of ATV.
Penalty:
1
HIV-ASSIST Notes:
Hyperbilirubinemia and diarrhea are common side effects of ATV.
Penalty:
1
HIV-ASSIST Notes:
Hyperbilirubinemia and diarrhea are common side effects of ATV.
Penalty:
0.5
HIV-ASSIST Notes:
Approximately 8-14% of adults using DRV will experience diarrhea.
Penalty:
0.5
HIV-ASSIST Notes:
Approximately 8-14% of adults using DRV will experience diarrhea.
Penalty:
0.5
HIV-ASSIST Notes:
Approximately 8-14% of adults using DRV will experience diarrhea.
Penalty:
1
HIV-ASSIST Notes:
EVG can cause nausea and diarrhea.
Penalty:
2
HIV-ASSIST Notes:
d4T can cause peripheral neuropathy that can be irreversible.
Penalty:
2
HIV-ASSIST Notes:
ddI can cause peripheral neuropathy that can be irreversible.
Penalty:
1.5
HIV-ASSIST Notes:
EFV is associated with neuropsychiatric effects and can exacerbate psychiatric symptoms. It may be associated with suicidality. Consider avoiding EFV-based regimens if possible. Symptoms usually subside or diminish after 2 to 4 weeks. Bedtime dosing may reduce symptoms. Risks include psychiatric illness, concomitant use of agents with neuropsychiatric effects, and increased EFV concentrations because of genetic factors or increased absorption with food.
Penalty:
0.5
HIV-ASSIST Notes:
RPV is associated with depression, suicidality, and sleep disturbances. DHHS guidelines suggest RPV can exacerbate psychiatric symptoms and state, "Consider avoiding RPV based regimens"
Penalty:
0.1
HIV-ASSIST Notes:
Insomnia, depression, and suicidality have been infrequently reported with INSTI use, primarily in patients with preexisting psychiatric conditions. DHHS guidance suggests 'patients with pre-existing psychiatric conditions on INSTI based regimens should be closely monitored"
Penalty:
0.1
HIV-ASSIST Notes:
Insomnia, depression, and suicidality have been infrequently reported with INSTI use, primarily in patients with preexisting psychiatric conditions. DHHS guidance suggests 'patients with pre-existing psychiatric conditions on INSTI based regimens should be closely monitored"
Penalty:
0.1
HIV-ASSIST Notes:
Insomnia, depression, and suicidality have been infrequently reported with INSTI use, primarily in patients with preexisting psychiatric conditions. DHHS guidance suggests 'patients with pre-existing psychiatric conditions on INSTI based regimens should be closely monitored"
Penalty:
0.1
HIV-ASSIST Notes:
Insomnia, depression, and suicidality have been infrequently reported with INSTI use, primarily in patients with preexisting psychiatric conditions. DHHS guidance suggests 'patients with pre-existing psychiatric conditions on INSTI based regimens should be closely monitored"
Penalty:
0.1
HIV-ASSIST Notes:
Insomnia, depression, and suicidality have been infrequently reported with INSTI use, primarily in patients with preexisting psychiatric conditions. DHHS guidance suggests 'patients with pre-existing psychiatric conditions on INSTI based regimens should be closely monitored"

Co-medication Interactions

We have identified the following possible drug interactions which HIV-ASSIST factors into ARV regimen selection, based on recommendations from DHHS guidelines, University of Liverpool HIV Drug Interaction Checker, and HIV-ASSIST clinician and pharmacist expertise. Penalties less than 1.0 are typically those representing minor interactions that can be mediated by dosage adjustments, whereas a penalty of 2.0 represents medically contraindicated ARVs.

Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Dose Descovy according to the concomitant antiretroviral.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0.3
HIV-ASSIST Notes:
Monitor renal function and haematological parameters and consider dose reduction if required
Liverpool Interaction Status:
Amber/Moderate: Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Concomitant treatment, especially acute therapy, with potentially nephrotoxic or myelosuppressive drugs (e.g. systemic pentamidine, dapsone, pyrimethamine, co-trimoxazole, amphotericin, flucytosine, ganciclovir, interferon, vincristine, vinblastine and doxorubicin) may also increase the risk of adverse reactions to zidovudine. If concomitant therapy with any of these drugs is necessary then extra care should be taken in monitoring renal function and haematological parameters and, if required, the dosage of one or more agents should be reduced. Retrovir Summary of Product Characteristics, Viiv Healthcare UK, Ltd, December 2018. The effects of dapsone (100 mg once daily) and/or trimethoprim (200 mg twice daily) on single doses of zidovudine (200 mg ) were investigated in 8 HIV-infected subjects. Zidovudine did not influence the pharmacokinetics of dapsone or trimethoprim. Dapsone had no effect on the pharmacokinetics of zidovudine. Trimethoprim significantly decreased renal clearance of zidovudine by 58%, with a concurrent 54% decrease in the mean urinary recovery of zidovudine. The combination effect of trimethoprim plus dapsone on the pharmacokinetics of zidovudine was similar to effect of trimethoprim alone. Zidovudine, trimethoprim and dapsone pharmacokinetic interactions in patients with human immunodeficiency virus infection. Lee BL, et al. Antimicrob Agents Chemother, 1996, 40: 1231-1236. , Summary:Coadministration of dapsone and zidovudine had no effect on the pharmacokinetics of either drug. However, concomitant treatment, especially acute therapy, with potentially nephrotoxic or myelosuppressive drugs (e.g. dapsone) may also increase the risk of adverse reactions to zidovudine. Monitor renal function and haematological parameters and consider dose reduction if required.
Penalty:
0.25
HIV-ASSIST Notes:
Coadministration of both drugs may increase the risk of peripheral neuropathy (additive toxicity)
Liverpool Interaction Status:
Amber/Moderate: Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. However, coadministration of both drugs may increase the risk of peripheral neuropathy (additive toxicity).
Penalty:
0.25
HIV-ASSIST Notes:
Coadministration of both drugs may increase the risk of peripheral neuropathy (additive toxicity)
Liverpool Interaction Status:
Amber/Moderate: Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration of dapsone (100 mg single dose) and didanosine buffered tablets (200 mg every 12 hours for 14 days) had no effect on dapsone AUC or Cmax. No dose adjustment is necessary for either medicinal product.Videx Summary of Product Characteristics, Bristol-Myers Squibb Pharmaceuticals Ltd, April 2016. When the buffered formulation of ddI (200 mg twice daily for 14 days) was coadministered with dapsone (100 mg single dose) to 6 HIV-infected subjects, there was no change in dapsone AUC or Cmax. Videx Prescribing Information, Bristol-Myers Squibb Company, December 2018. The effect of didanosine (200 mg twice daily, buffered tablets) on the pharmacokinetics of dapsone (100 mg) was investigated in 6 HIV-infected subjects. There were no significant differences in dapsone pharmacokinetics when administered alone or with didanosine. Mean values for didanosine Cmax and AUC were 1.72±0.40 vs. 1.73±0.27 µg/ml and 36.3±15.9 vs. 38.1±15.1 µg.h/ml (alone vs. combination), respectively. Effects of the antacids in didanosine tablets on dapsone pharmacokinetics. Sahai J et al. Ann Intern Med, 1995, 123: 584-587. , Summary:Coadministration with didanosine gastro-resistant capsules has not been studied. Coadministration of didanosine buffered tablets had no significant effect on dapsone AUC or Cmax. However, coadministration of both drugs may increase the risk of peripheral neuropathy (additive toxicity).
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Studies using human liver microsomes indicated that dapsone did not affect the formation of nevirapine hydroxylated metabolites. Viramune Summary of Product Characteristics, Boehringer Ingelheim Ltd, November 2019., Summary:In vitro studies showed that dapsone did not affect the formation of nevirapine hydroxylated metabolites. No data on the effect of nevirapine on dapsone.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Doravirine does not inhibit or induce CYP enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Based on known metabolic profiles, a clinically significant interaction is not expected between lopinavir and dapsone. Kaletra Summary of Product Characteristics, AbbVie Ltd, January 2021. Based on known metabolic profiles, a clinically significant interaction is not expected between lopinavir and dapsone. Kaletra Prescribing Information, AbbVie Inc, October 2020., Summary:Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but can not be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
LHPG Comment: No data with fosamprenavir. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but cannot be excluded., Summary:Coadministration has not been studied. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but cannot be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. The metabolism of dapsone is mainly N-acetylation, with a component of N-hydroxylation, and is via multiple cytochrome P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
LHPG Comment: Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but can not be excluded., Summary:Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but can not be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Based on known metabolic profiles, clinically significant drug interactions are not expected between Reyataz and dapsone. Reyataz US Prescribing Information, Bristol-Myers Squibb Company, March 2018., Summary:Coadministration has not be studied. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but cannot be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Based on known metabolic profiles, clinically significant drug interactions are not expected between Evotaz and dapsone. Evotaz US Prescribing Information Bristol-Myers Squibb Company, March 2018. , Summary:Coadministration has not be studied. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but cannot be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Based on known metabolic profiles, clinically significant drug interactions are not expected between Reyataz and dapsone. Reyataz US Prescribing Information, Bristol-Myers Squibb Company, March 2018., Summary:Coadministration has not be studied. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but cannot be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but cannot be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but cannot be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely, but cannot be excluded.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Clinically significant interactions are unlikely.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dapsone is mainly metabolized by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Dolutegravir is not expected to inhibit or induce CYP450 enzymes at clinically relevant concentrations.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Bictegravir does not inhibit or induce CYP enzymes; emtricitabine and tenofovir alafenamide do not interact with dapsone’s metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Dapsone is mainly metabolized by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes. Cabotegravir does not inhibit or induce CYP enzymes at clinically relevant concentrations.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP P450 enzymes.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. No drug interaction studies have been conducted with ibalizumab: based on ibalizumab’s mechanism of action and target-mediated drug disposition, drug-drug interactions are not expected. Dapsone undergoes hepatic metabolism whereas ibalizumab, a monoclonal antibody binding to the CD4 receptor, is likely to be eliminated via intracellular catabolism similarly to other monoclonal antibodies.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Metabolism of dapsone is mainly by N-acetylation with a component of N-hydroxylation, and is via multiple CYP enzymes. Fostemsavir is a prodrug and is hydrolysed to the active compound temsavir in the small intestine. Temsavir is mainly metabolized by esterase-mediated hydrolysis with a small contribution of CYP3A4. Temsavir does not inhibit or induce CYP enzymes.