Recommendations on the simultaneous use of other classes of drugs antiarrhythmic drugs (bepridil, systemic lidocaine, quinidine, amiodarone, flecainide, propafenone) The combination of bayer primobolan depot/ ritonavir may increase serum concentrations of bepridil, lidocaine, quinidine, amiodarone, flecainide and propafenone.
With simultaneous use of this combination and these antiarrhythmics is recommended to be careful and, if possible, to monitor the concentrations of these agents in plasma. Digoxin In all studies on the interaction ritonavir (600/100 mg 2 times a day) and a single dose of digoxin ( 0.4 mg) was shown to increase the final digoxin concentration in the plasma by 77%. It is recommended to initially prescribe the lowest dose of digoxin and measure serum concentration to obtain the desired clinical effect while the appointment with itonavir.
Anticoagulants combination / ritonavir can influence warfarin plasma concentrations. With simultaneous use of warfarin, and this combination is recommended to monitor international normalized ratio. Anticonvulsants (phenobarbital, phenytoin and carbamazepine) Phenobarbital and phenytoin are inducers of the CYP450 isoenzymes of cytochrome. Combination r is not recommended in combination with these drugs, because it can cause a significant reduction in the plasma concentration of darunavir and thus decrease its therapeutic effect. Cooperation between the combination study ritonavir (600/100 mg twice a day 2 ) and carbamazepine (200 mg, 2 times a day) showed that the concentration of darunavir in this case does not change, while the concentration of ritonavir decreased by 49%. The concentration of carbamazepine is increased by 45%. We should be measured carbamazepine concentrations and its dose should be adjusted according to clinical manifestations. Thus, the dose of carbamazepine can be reduced by 25-50% when combined with bayer primobolan depot ritonavir
.Antidepressants (trazodone, desipramine) The combined use of ritonavir with desipramine and trazodone may result in increased concentrations of trazodone and desipramine in plasma. It can cause side effects such as nausea, dizziness, decreased blood pressure, fainting. If necessary, the joint use of these drugs and Prezista ® / ritonavir should be careful and consider using smaller doses of trazodone and desipramine. Benzodiazepines (midazolam parenterally) The combined use ritonavir with parenterally administered midazolam may result in increased plasma concentrations of midazolam. In a joint application should be careful clinical monitoring and prompt action in case of respiratory depression or prolonged sedation. You should consider lowering the dose of midazolam, particularly in the case of long-term therapy. The use ritonavir with oral midazolam is contraindicated.
Antipsychotics (risperidone tiorizadin) When the joint application of neuroleptics with ritonavir, concentrations in plasma may be increased, resulting in a joint application should reduce the dose of neuroleptics. colchicine in a joint application with colchicine bayer primobolan depotritonavir may increase plasma concentration of colchicine. The recommended scheme of changing the dose of colchicine. For the treatment of gout exacerbations in patients receiving combination ritonavir, colchicine recommended dose is 0.6 mg (1 tablet) and 0.3 mg (½ tablet) over 1 hour. The course of treatment should be repeated no earlier than 3 days. For the prevention of relapse for patients receiving the combination of ritonavir, the recommended dose of colchicine is 0.3 mg every day or every other day. For the treatment of familial Mediterranean fever in patients receiving combination itonavir, colchicine maximum dose should be 0.6 mg once a day (or 0.3 mg twice a day). Patients with impaired renal or hepatic function should not be given colchicine when combined with ritonavir. Blockers “slow” calcium channels Plasma concentrations blockers “slow” calcium channel blockers (eg, felodipine, nifedipine, nicardipine) may increase when their simultaneous application with a combination of ritonavir. In such situations, the condition should be closely monitored patients. Clarithromycin Study of the interaction between the combination of darunavir / ritonavir (400 mg / 100 mg twice daily) and clarithromycin (500 mg twice daily) showed that clarithromycin plasma concentration increased by 57% whereas darunavir concentration remained unchanged. In patients with impaired renal function is recommended to reduce the dose of clarithromycin. Dexamethasone Dexamethasone for admission into the bloodstream induces the isoenzyme in the liver, which leads to a decrease in plasma concentration of darunavir. This can lead to a reduction of its therapeutic effect. It is recommended to be careful at simultaneous application of dexamethasone and darunavir. Bosentan With simultaneous use of bosentan and the combination ritonavir may increase plasma concentrations of bosentan in. Patients receiving the combinatior for at least 10 days is recommended starting dose of 62.5 mg bosentan every day or every other day depending on individual tolerability. For patients taking bosentan and beginning therapy ritonavir, it is recommended to cancel the bosentan for at least 36 hours prior to initiation of therapy ritonavir. how much to inject for weight loss
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